Association between the use of individual beta-lactam antibiotics and neuromuscular blocking agents on the incidence of perioperative hypersensitivity in cancer patients: an 8-year single-center retrospective study

Association between the use of individual beta-lactam antibiotics and neuromuscular blocking agents on the incidence of perioperative hypersensitivity in cancer patients: an 8-year single-center retrospective study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 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Data may be preliminary. 4 August 2025 V1 Latest version Share on Association between the use of individual beta-lactam antibiotics and neuromuscular blocking agents on the incidence of perioperative hypersensitivity in cancer patients: an 8-year single-center retrospective study Authors : Bailleul Amaury , Sciaraffa Cédric , and Demiri Migena 0000-0001-6247-9721 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.175429455.50818154/v1 108 views 89 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background : Perioperative hypersensitivity (POH) is a rare event linked to high morbidity and mortality. Objective : We assessed the incidence of POH associated with beta-lactam antibiotics (BLAs) and neuromuscular blocking agents (NMBAs) use among adult cancer patients. Methods : Our study included 83 eligible individuals with features consistent with grade I to IV POH who received general, regional, or sedation anesthesia from January 1 st , 2015 to December 31 st , 2023 at our hospital. Patient characteristics and exposure to BLAs and NMBAs were extracted from the computerized medical record system allowing the number of single exposures to each drug to be determined over the study period. Any POH reaction suspected by the anesthesiologist was followed by allergology consultation. A patient was considered allergic if an allergist determined that the results were positive in accordance with current guidelines to avoid false-positive reactions. Results : Over the study period, 62 of the 83 patients identified with POH were investigated by an allergologist. A total of 32 patients had a positive skin test indicative of an IgE-mediated reaction, of which 10 (30%) developed POH to amoxicillin/clavulanic acid, 3 (9%) to cefazolin, 1 to cefoxitin (3%), 6 (19%) to atracurium, 4 (12%) to rocuronium, and 5 (16%) to succinylcholine. Intensive care hospitalization was required for 37 (45%) and surgery was canceled for 29 (35%) of these patients. Conclusions : The onset of a POH was a rare event but associated with significant morbidity, potentially affecting the patient’s cancer prognosis. Among NMBAs, the incidence of POH was comparable following exposure to rocuronium and atracurium and higher in response to succinylcholine. Supplementary Material File (pds-25-0591-file001.docx) Download 160.09 KB Information & Authors Information Version history V1 Version 1 04 August 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords beta-lactam antibiotics cancer patient neuromuscular blocking agents perioperative hypersensitivity Authors Affiliations Bailleul Amaury Gustave Roussy View all articles by this author Sciaraffa Cédric Gustave Roussy View all articles by this author Demiri Migena 0000-0001-6247-9721 [email protected] Gustave Roussy View all articles by this author Metrics & Citations Metrics Article Usage 108 views 89 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Bailleul Amaury, Sciaraffa Cédric, Demiri Migena. Association between the use of individual beta-lactam antibiotics and neuromuscular blocking agents on the incidence of perioperative hypersensitivity in cancer patients: an 8-year single-center retrospective study. Authorea . 04 August 2025. DOI: https://doi.org/10.22541/au.175429455.50818154/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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