Outpatient Penicillin Allergy Testing in Pregnant Women Who Report an Allergy

Area of Science:

• Obstetrics and Gynecology
• Allergy and Immunology
• Pharmacology

Background:

• Penicillin allergy is common, but often inaccurately reported.
• Accurate penicillin allergy testing is crucial for appropriate antibiotic selection during pregnancy.
• Unnecessary avoidance of penicillin can lead to the use of broader-spectrum antibiotics with potential risks.

Purpose of the Study:

• To assess the feasibility, acceptability, and safety of performing penicillin allergy testing in an outpatient setting for pregnant women.
• To determine the rate of negative penicillin allergy test results in this population.
• To identify factors influencing participation in penicillin allergy testing during pregnancy.

Main Methods:

• A prospective cohort study was conducted at a large academic hospital.
• Pregnant women with self-reported penicillin allergy were recruited between 14 and 36 weeks of gestation.
• Allergy testing was performed, and outcomes including test results, feasibility, acceptability, and adverse events were recorded.

Main Results:

• 58% of eligible pregnant women accepted penicillin allergy testing.
• The feasibility rate for completing the testing was 68%.
• 93% of tested women had negative results, with only 4% experiencing mild systemic reactions and no serious adverse events.
• Women with public insurance were less likely to undergo testing.

Conclusions:

• Outpatient penicillin allergy testing is a feasible and acceptable procedure for pregnant women.
• The testing demonstrates a high rate of negative results, confirming penicillin tolerance in most self-reported allergic individuals.
• These findings support the routine implementation of penicillin allergy testing in prenatal care to optimize antibiotic management.