Penicillin skin testing in pregnant women with a history of penicillin allergy and group B streptococcus colonization.

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.