Penicillin is the preferred treatment for infections during pregnancy. It is used to:
Prevent Group B Strep infections in infants and people who give birth (1 in 3 pregnant people have Group B Strep).
Prevent surgical site infections during C sections (1 in 5 births).
Treat prolonged rupture of membranes and fever during the birth.
About 1 in 10 people have a penicillin allergy listed in their health record. When this type of allergy is listed, doctors often choose other antibiotics. The other medicine may not work as well and could lead to complications or a long hospital stay.
Why do I need penicillin testing?
It can help figure out if it is safe for you to use penicillin and other related medicines. Most of the patients who are tested are cleared to safely use penicillin again.
Who needs penicillin allergy evaluation?
Low risk – Patients who only had nausea, diarrhea, vomiting or headache do not need testing. They can safely use penicillin.
Moderate risk – Patients who had hives, swelling or rash will be referred for an Allergy consult.
High risk –Patients who had severe skin reactions such as Stevens Johnson syndrome or DRESS, or anaphylaxis will not be referred for an allergy consult. Instead, other antibiotics would be used.
How does penicillin allergy testing work?
This may involve one or two-steps that can take about 2-3 hours. The type of testing will depend on your past penicillin reaction.
Step 1: Some patients may first need a skin test. This may start with a skin scratch test. Then, you may have the medicine placed just under the skin using tiny needles. The test is very safe and fairly painless.
Step 2: After a negative skin test, you will be given a single dose or two graded doses (first small dose and second full dose) of oral amoxicillin over about 60-90 minutes as a “challenge.” This is to prove you can take it safely. We will monitor you during this time.
Is penicillin testing and challenge safe?
Recent studies show this is a safe test during pregnancy.
How do I prepare for the test?
Do not take antihistamines for 7 days before the test. This is very important. This means you should not take any allergy pills, cold medicines, etc. in the 7 days before your test. These include:
Benadryl®
Claritin®
Zyrtec®
Allegra®
Any other medicines with antihistamines
What happens after the test?
A negative skin test and challenge makes future reactions very unlikely. The warning about penicillin allergy will be removed from your health record. Your doctors will be told that you can safely use penicillin again in the future. Negative testing alone cannot guarantee that you will not have a future reaction, like a rash. Though, rashes are less likely after a negative test.
When should I be tested?
It is best to be tested before getting pregnant. But, you can also have the test any time during your second or third trimesters of pregnancy.
When should I be tested?
It is best to be tested before getting pregnant. But, you can also have the test any time during your second or third trimesters of pregnancy.