Document Detail


Management of group B Streptococcus in pregnant women with penicillin allergy.
MedLine Citation:
PMID:  17694964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether group B Streptococcus (GBS)-colonized pregnant women who report a history of penicillin allergy can safely undergo diagnostic evaluation to rule out or confirm the potential for an IgE-mediated (allergic) reaction to penicillin. STUDY DESIGN: Over 18 months, all pregnant women with GBS-positive vaginal/rectal cultures and a history of penicillin allergy were referred to the Department of Allergy and Immunology for a history and possible skin testing. Patients who had experienced anaphylaxis were advised to continue avoiding penicillin and were not skin tested. Women without such a history underwent immediate hypersensitivity (percutaneous and intradermal) testing using 2 penicillin reagents with controls. If skin testing was negative, intrapartum antimicrobial prophylaxis with intravenous penicillin was administered. RESULTS: Of 28 patients with both GBS colonization and "penicillin allergy," 25 (89%) had negative skin testing to penicillin and received intrapartum penicillin for GBS prophylaxis without adverse reactions. Skin testing was positive in 2 patients, and intrapartum penicillin was not administered. Penicillin skin testing was not performed on 1 patient due to a history of anaphylaxis from penicillin. CONCLUSION: These results indicate that most pregnant women reporting penicillin allergy undergo negative skin tests and are able to safely receive intrapartum penicillin GBS prophylaxis.
Authors:
Elliot H Philipson; David M Lang; Steven J Gordon; Janet M Burlingame; Stephen P Emery; Mercedes E Arroliga
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  52     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-08-14     Completed Date:  2007-09-13     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Hillcrest Hospital, Cleveland Clinic Foundation, 6770 Mayfield Road, Suite 336, Mayfield Heights, OH 44124 , USA. philipe@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Drug Hypersensitivity / diagnosis*
Female
Humans
Immunoglobulin E / immunology
Infectious Disease Transmission, Vertical / prevention & control
Penicillins / administration & dosage*,  immunology*
Pregnancy
Pregnancy Complications, Infectious / drug therapy*,  prevention & control
Skin Tests
Streptococcal Infections / drug therapy*,  prevention & control
Streptococcus agalactiae / drug effects*
Chemical
Reg. No./Substance:
0/Penicillins; 37341-29-0/Immunoglobulin E

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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