Intraoperative Antimicrobial Prophylaxis in Elective Cataract Surgery Patients

The true prevalence of IgE-mediated allergy in those self-identifying as penicillin allergic sits at less than 1% and cross-reactivity between penicillins and cephalosporins has been reported in up to 10% of these patients for first and second-generation cephalosporins, such as cefuroxime. There is a lack of evidence for significant cross-reactivity of intracameral cefuroxime in penicillin allergic patients. This has led to significant variation in intraoperative antimicrobial prophylaxis for cataract surgery in this setting. This Concise Practice Point provides recommendations based on published evidence on this varied area of practice. Updated December 2024 to include additional alternatives for patients at possible risk of prophylaxis.