Women's Health

February 16, 2023

Penicillin allergy test recommended for pregnant women

Vanderbilt experts say getting rid of unnecessary penicillin allergy labels allows women to receive better treatments for common infections during pregnancy and delivery.

Pregnant women previously labeled with a penicillin allergy who receive allergy testing are often able to disprove the allergy, which can allow them to receive better treatments for common infections during pregnancy and delivery.

Approximately 13-15% of all pregnant women have a penicillin allergy listed in their medical charts, but typically 98-99% of them tested as adults won’t have an ongoing allergy to the medication.

Penicillin medications are the first line of treatment for many infections such as mastitis, endometritis or group B strep infections, a key cause of meningitis in newborns.

“We see this as an opportunity to improve the quality of the care that we deliver and to implement a new standard of care for pregnant patients. By getting rid of unnecessary penicillin allergy labels, it means that the mom can receive the right treatment at the right time,” says Cosby Stone Jr., MD, MPH, assistant professor of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine.

Since 10% to 20% of all pregnant women will be colonized with a group B strep organism that could affect the health of their newborns, ensuring clarity on penicillin allergies enables doctors to treat those organisms with greater effectiveness and fewer complications.

Medications related to penicillin have greater efficacy when used during C-sections. Administering alternative treatments can result in delayed recovery and unnecessary adverse effects.

“As physicians working with our patients, we’re all thinking through, ‘What can I do to make sure birth goes as smoothly as possible, as safely as possible?’ Even if you’re tested and you find you are one of the few who is still allergic, we can provide guidance on other drugs that will be the most effective and safe for you and the baby,” Stone said.

Testing for a penicillin allergy is conducted in multiple ways. After physicians assess the likelihood of a reaction, they will either conduct skin testing or administer a dose of amoxicillin in-office. Both options are safe for pregnant women.

“I tell my patients that I absolutely think it is important and necessary to be tested for a penicillin allergy not just for your pregnancy, but for the rest of your life. Oftentimes a penicillin type antibiotic is the best option to treat an infection. If you are able get your allergy cleared, then you can receive the preferred treatment in the future. This is something that can impact your health care in the future,” says Jennifer Thompson, MD, fellowship program director, Maternal-Fetal Medicine.

“We feel like it’s a core part of our mission to educate our patients and other individuals because we know that removing unnecessary penicillin allergies is improving outcomes when they need treatment,” Stone said.

To find information about penicillin allergy testing at Vanderbilt University medical Center visit: https://www.vanderbilthealth.com/service-line/asthma-sinus-and-allergy-program.