Eric Macy1. 1. Department of Allergy, Kaiser Permanente Southern California, San Diego Medical Center, USA.
Abstract
BACKGROUND: The safety and utility of penicillin skin testing (PST) in pregnant women with a history of penicillin allergy and group B streptococcus (GBS) colonization have not been studied. OBJECTIVE: To document the safety and utility of PST in pregnant women with a history of penicillin allergy and GBS colonization. METHODS: Pregnant GBS culture-positive women with a history compatible with an IgE-mediated or unknown reaction to a penicillin-class antibiotic were recruited for PST. If PST results were negative, penicillin-class antibiotics were recommended for GBS prophylaxis. Adverse reactions associated with PST or antibiotic use from the time of PST through delivery and 6 months post partum were reported. RESULTS: In 56 enrolled patients, there were only 2 mild adverse reactions (4%) associated with PST and 3 positive PST results (5%). Of the 53 PST-negative patients, 47 (89%) received at least 1 course of penicillin. There were 2 delayed-onset rashes associated with the use of intrapartum penicillins and 1 immediate-onset rash with intrapartum vancomycin therapy in a PST-positive woman. There were 7 reactions (6%) associated with 122 antibiotic courses administered. CONCLUSIONS: Penicillin skin testing can be performed safelyin pregnant women and, if the results are negative, allows penicillins to be used safely at delivery for GBS prophylaxis.
BACKGROUND: The safety and utility of penicillin skin testing (PST) in pregnant women with a history of penicillinallergy and group B streptococcus (GBS) colonization have not been studied. OBJECTIVE: To document the safety and utility of PST in pregnant women with a history of penicillinallergy and GBS colonization. METHODS: Pregnant GBS culture-positive women with a history compatible with an IgE-mediated or unknown reaction to a penicillin-class antibiotic were recruited for PST. If PST results were negative, penicillin-class antibiotics were recommended for GBS prophylaxis. Adverse reactions associated with PST or antibiotic use from the time of PST through delivery and 6 months post partum were reported. RESULTS: In 56 enrolled patients, there were only 2 mild adverse reactions (4%) associated with PST and 3 positive PST results (5%). Of the 53 PST-negative patients, 47 (89%) received at least 1 course of penicillin. There were 2 delayed-onset rashes associated with the use of intrapartum penicillins and 1 immediate-onset rash with intrapartum vancomycin therapy in a PST-positive woman. There were 7 reactions (6%) associated with 122 antibiotic courses administered. CONCLUSIONS:Penicillin skin testing can be performed safelyin pregnant women and, if the results are negative, allows penicillins to be used safely at delivery for GBS prophylaxis.
Authors: Cassandra R Duffy; Yongmei Huang; Maria Andrikopoulou; Conrad N Stern-Ascher; Jason D Wright; Mary E D'Alton; Alexander M Friedman Journal: J Matern Fetal Neonatal Med Date: 2020-03-11
Authors: Anna R Wolfson; Christian M Mancini; Aleena Banerji; Xiaoqing Fu; Allison S Bryant; Neelam A Phadke; Erica S Shenoy; Weaam Arman; Yuqing Zhang; Kimberly G Blumenthal Journal: J Allergy Clin Immunol Pract Date: 2020-11-16