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Elliot Campbell, MD, FAAD was a contributor to an article published in Dematologic Surgery (Official Journal of the American Society for Dermatologic Surgery (ASDS). The article discusses… if cephalexin should be used as a first-line prophylactic antibiotic in dermatologic surgery for patients with penicillin allergy.
Dr. Elliott Campbell
Dr. Elliott Harrison Campbell M.D., F.A.A.D. is a board-certified dermatologist by the American Board of Dermatology with specialized fellowship training in Mohs micrographic surgery and dermatologic oncology. He earned his undergraduate and medical degrees from the University of Kentucky, followed by a Dermatology residency and a fellowship in Mohs Surgery and Dermatologic Oncology at the Mayo Clinic.
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The following is an abstract from the article…
Approximately 10% of patients report penicillin allergy. Based on historical guidelines, patients with a penicillin allergy should receive an alternative to cephalexin for prophylaxis in dermatologic surgery.
Objective
To determine, based on evidence, if cephalexin should be used as a first-line prophylactic antibiotic in dermatologic surgery for patients with penicillin allergy.
Methods
Systematic review of the literature was performed with defined search terms.
Results
Less than 5% of those with penicillin allergy labels have a true penicillin allergy. For patients with true, persistent penicillin allergy, there is an overall low cross-reactivity with cephalosporins, especially with cephalosporins that do not share identical R1 side chain. The first-generation cephalosporins, including cephalexin, have a slightly higher risk of cross-reactivity in patients with reported allergy to amino-penicillins (amoxicillin, ampicillin) but not other penicillins. The risk of severe cross-reactivity of cephalosporins in patients with low-risk penicillin allergies is extremely low. Cephalexin has a superior side effect profile and efficacy compared to alternatives.
Conclusion
Cephalexin should be used as the first-line prophylactic antibiotic in dermatologic surgery for patients with documented penicillin allergy, including anaphylaxis. There may be a higher risk of cross-reactivity with cephalexin in patients with a confirmed amino-penicillin allergy.
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About Dermatology Associates of Northern Kentucky
About Dermatology Associates of Northern KentuckyDermatology Associates of Northern Kentucky offers a range of services for all age groups, including general and pediatric dermatology, dermatologic surgery, Mohs Micrographic surgery, laser and cosmetic procedures, and Dermatopathology.
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