Beta-lactam antibiotics such as cefazolin are first-line agents for preoperative prophylaxis, whereas clindamycin is often administered to patients with a reported penicillin allergy. 1 Recent studies have reported increased resistance to clindamycin in Staphylococcus aureus (SA) isolates from both pediatric and adult populations, and these changes may have implications for surgical site infection (SSI) prophylaxis and empirical management. 2 , 3 Antibiotic resistance trends of SA isolates recovered from SSIs in adults in the United States have not been recently described.