Outpatient Penicillin Allergy Testing in Pregnant Women Who Report an Allergy

被引:23
作者
Desravines, Nerlyne
Waldron, Jamie
Venkatesh, Kartik K.
Kwan, Mildred
Boggess, Kim A. [1 ]
机构
[1] Univ N Carolina, Div Maternal Fetal Med, Dept Obstet & Gynecol, Chapel Hill, NC 27515 USA
关键词
GROUP-B STREPTOCOCCUS; DESENSITIZATION; MANAGEMENT;
D O I
10.1097/AOG.0000000000004213
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: To estimate the feasibility, acceptability, and safety of outpatient penicillin allergy testing among pregnant women. METHODS: We conducted a prospective cohort study at a large academic hospital from March 2019 to March 2020. We recruited pregnant women with a self-reported penicillin allergy who underwent allergy testing between 14 0/7 and 36 6/7 weeks of gestation. RESULTS: Of 127 eligible women pregnant women, 74 (58%, 95% CI 4-67%) accepted allergy testing. Fifty completed or intended to complete allergy testing, yielding a feasibility rate of 68% (95% CI 56-78%). Among the 46 women actually tested (who ranged in age from 18 to 42), 93% (95% CI 68-100%) had a negative test result. A systemic reaction (symptoms consistent with anaphylaxis) occurred in only 2 women (4%, 95% CI 0.5-15%) despite 20 (43%) reporting a severe allergy. No woman suffered an adverse event as a result of allergy testing. In multivariate analysis adjusting for age and parity, women with public insurance had decreased odds of undergoing penicillin allergy testing (adjusted odds ratio 0.24, 95% CI 0.08-0.69). CONCLUSION: Outpatient penicillin allergy testing is acceptable and feasible in pregnancy.
引用
收藏
页码:56 / 61
页数:6
相关论文
共 18 条
[1]   Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population [J].
Albin, Stephanie ;
Agarwal, Shradha .
ALLERGY AND ASTHMA PROCEEDINGS, 2014, 35 (06) :489-494
[3]   Natural evolution of skin test sensitivity in patients allergic to β-lactam antibiotics [J].
Blanca, M ;
Torres, MJ ;
García, JJ ;
Romano, A ;
Mayorga, C ;
de Ramon, E ;
Vega, JM ;
Miranda, A ;
Juarez, C .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1999, 103 (05) :918-924
[4]  
Blumenthal Kimberly G, 2020, JAMA, V323, P1216, DOI 10.1001/jama.2019.19809
[5]   Penicillin Allergy [J].
Castells, Mariana ;
Khan, David A. ;
Phillips, Elizabeth J. .
NEW ENGLAND JOURNAL OF MEDICINE, 2019, 381 (24) :2338-2351
[6]   Use of Prophylactic Antibiotics in Labor and Delivery [J].
Coleman, Jenell ;
Murtha, Amy ;
Silverman, Neil S. .
OBSTETRICS AND GYNECOLOGY, 2018, 132 (03) :E103-E119
[7]   Time Has Come for Routine Penicillin Allergy Testing in Obstetrics [J].
Cook, Elizabeth ;
Ramirez, Mildred ;
Turrentine, Mark .
AJP REPORTS, 2020, 10 (01) :E15-E19
[8]  
Desai Shilpa H, 2017, Perm J, V21, P16, DOI 10.7812/TPP/16-080
[9]   Intrapartum Group B Streptococcus Antibiotic Prophylaxis in Penicillin Allergic Pregnant Women [J].
Desravines, Nerlyne ;
Venkatesh, Kartik K. ;
Hopkins, Austin ;
Waldron, Amie ;
Grant, Megan ;
McGuire, Colleen ;
Boggess, Kim A. .
AJP REPORTS, 2019, 9 (03) :e238-e243
[10]   Penicillin Skin Testing, Challenge, and Desensitization in Pregnancy: A Systematic Review [J].
Furness, Allison ;
Kalicinsky, Chrystyna ;
Rosenfield, Lana ;
Barber, Colin ;
Poliquin, Vanessa .
JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA, 2020, 42 (10) :1254-+