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
