Effects of different antibiotics injection during spinal anesthesia and Infection management after lower limb surgeries in patients with Beta-lactam Allergy

This study compared cefazolin with second-line antibiotics to assess the prevalence of SSIs within 90 days after joint replacement surgery and interoperative HSRs among patients with a diagnosis of penicillin or cephalosporin allergy.Demographics, comorbidities, immunomodulatory medications, allergy history, perioperative medications, and laboratory test results were all collected from the electronic health record. Patients who underwent multiple joint replacements in various procedures were counted as separate encounters. Joint replacements on both sides carried out during the same procedure were counted as one encounter. Based on the symptoms that were reported, beta-lactam allergic reaction histories were divided into immediate, delayed, and undetermined categories. There were descriptions of anaphylaxis, respiratory distress, cardiovascular symptoms, edema, and hives among the immediate allergic reactions. Delayed allergic reactions were described as pruritis, nephritis, hepatitis, and blood cell dysfunction (neutropenia, thrombocytopenia), among other dermatological findings and conditions. The causes of all other allergic reactions were labeled as unknown.The average time from surgery to SSI was 24 days in the cefazolin group and 21 days in the clindamycin and/or vancomycin group. There were fewer superficial incisional infections (0.7% vs 1.9%) and prosthetic joint infections (0.1% vs 1.9%) in the cefazolin group.According to our research, using cefazolin as a perioperative antibiotic for infection prevention during total joint arthroplasty in patients who have been diagnosed as being allergic to beta-lactams is associated with fewer postoperative SSIs without raising interoperative HSRs.