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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(01): e15-e19
DOI: 10.1055/s-0039-3401801
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Time Has Come for Routine Penicillin Allergy Testing in Obstetrics[*]

Elizabeth Cook
1   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
Mildred Ramirez
1   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
Mark Turrentine
1   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
› Author Affiliations Funding None.
Further Information

Publication History

15 August 2019

15 October 2019

Publication Date:
04 February 2020 (online)

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Abstract

Objective This study evaluates penicillin allergy during pregnancy to estimate the proportion that could benefit from penicillin allergy testing.

Study Design Retrospective cohort study of women with penicillin allergy that delivered from January 1, 2018 to December 31, 2018.

Results Among 6,321 deliveries, 446 (7%) were identified with penicillin allergy. Nine percent (41/446) had no documentation of allergy severity. Allergies associated with intolerance, low, moderate, or high risk of anaphylaxis were reported in 6% (25/446), 40% (177/446), 32% (142/446), and 14% (61/446), respectively. Nearly 74% (330/446) received an antibiotic either antepartum, at delivery, or within 6 weeks of postpartum. The majority of women, 81% (360/446) (i.e., undocumented reactions, low, or moderate risk of anaphylaxis) would have been eligible for penicillin allergy testing. Greater appropriate utilization of antibiotics occurred in women with a high 80% (39/49) or moderate risk of anaphylaxis 70% (79/112) versus low risk of anaphylaxis 55% (64/117), history of intolerance 40% (8/20), or undocumented reaction 19% (6/32), p ≤ 0.01.

Conclusion Most women who report a penicillin allergy during pregnancy would be candidates for penicillin allergy testing. With the high rate of antibiotic interventions in pregnant women who report a penicillin allergy, consideration should be given for penicillin allergy assessment.

Keywords

penicillin allergy - pregnancy - penicillin allergy skin testing

* Presented as an abstract at the Infectious Disease Society of Obstetrics and Gynecology meeting, August 2019, Big Sky, MT.


 

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