Intraoperative anaphylaxis to bacitracin during pacemaker change and laser lead extraction

Use of antimicrobial agent pocket irrigation for cardiovascular implantable electronic device infection prophylaxis: Results from an international survey

“…For example, bacitracin appeared to be widely used and well tolerated, and our survey results showed that bacitracin is the most commonly used antibiotic solution (48%) for pocket irrigation. Bacitracin, however, has not been shown effective in any situation, and may cause serious complications such as anaphylaxis, which was also reported by one respondent to this survey, whose patient suffered an anaphylactic reaction to bacitracin solution resulting in pulseless electrical activity arrest. At last, only a small percentage of respondents (14%) used topical antimicrobial agents post implantation for infection prophylaxis.…”

Successful resuscitation of a patient who developed cardiac arrest from pulsed saline bacitracin lavage during thoracic laminectomy and fusion

“…The incidence of anaphylaxis during surgery is approximately 1:10,000 to 1:20,000. All 8 cases of intraoperative anaphylaxis to bacitracin resulted in cardiovascular collapse [1]. Bacitracin was the ninth most common allergen noted between 1998 and 2000, representing a steady increase from previous years [1].…”

“…All 8 cases of intraoperative anaphylaxis to bacitracin resulted in cardiovascular collapse [1]. Bacitracin was the ninth most common allergen noted between 1998 and 2000, representing a steady increase from previous years [1]. Flushing, urticaria, and edema occurred in almost 75% of anaphylaxis cases during general anesthesia [2].…”

Anaphylaxis after application of topical bacitracin-neomycin powder

“…3 Twenty additional cases were subsequently described with different types of exposure, including intraoperative irrigations during cardiac procedures. 4 However, only a few case reports have highlighted the allergological workup that was used to identify the causative agent when an association of antibiotics was involved.…”