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Strymish JM, O' Brien W, Itani K, Gupta K, Branch-Elliman W. What Is the Primary Driver of Preoperative Vancomycin Use? It's Not Methicillin-resistant Staphylococcus aureus-or Allergy. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2020 Dec 17; 71(10):2732-2735.
Factors driving vancomycin surgical prophylaxis are poorly understood. In a national Veterans Affairs cohort with manually validated data, surgical specialty (cardiac, orthopedics) and perception of high facility methicillin-resistant Staphylococcus aureus (MRSA) prevalence-not MRSA colonization-were the primary drivers of prescribing. A ß-lactam allergy was the second most common reason. These data may inform perioperative stewardship.