Surgical antibiotic prophylaxis: current issues of beta-lactams use

Abstract

The most common prescriptions for antibiotics in surgery are in the area of surgical antibiotic prophylaxis. According to clinical guidelines, beta-lactams, in particular, first and second generation cephalosporins, and in some cases aminopenicillins, should be used as drugs of choice. These drugs are leaders with regards to assessing the contribution of drugs of various pharmacological groups to the formation of drug allergies. However, real clinical practice reveals fewer cases of true allergy to beta-lactams compared to self-reported data by patients. Both underestimation and overestimation of the risks of hypersensitivity reactions with cephalosporins and penicillins is critical to the ultimate outcome of patient management. This review includes the main characteristics of drugs used for antibiotic prophylaxis in surgery and highlights topical issues of beta-lactam allergy and management of patients with various types of hypersensitivity reactions.