Improving surgical site infection prophylaxis with penicillin allergy testing (PAT) in our gynecologic oncology (GON) patients: A quality improvement initiative

Patients reporting a penicillin allergy have 50% higher odds of surgical site infection (SSI) related to the use of second-line antibiotics. However, ≥90% of penicillin (PCN) allergies are not hypersensitivity reactions. A retrospective review of SSI in our patients revealed that 80% of PCN-allergic patients received second-line antibiotics for SSI prophylaxis, while cefazolin is the first-line antibiotic for SSI prophylaxis. We undertook a quality improvement initiative to increase the use of cefazolin for SSI prophylaxis by increasing preoperative penicillin allergy testing (PAT) in PCN-allergic patients.