When and How to Tackle Penicillin Allergy During Pregnancy.

Pregnant women who report penicillin allergy have higher use of broader-spectrum antibiotics and associated complications, yet few have confirmed allergy when evaluated. Proactive evaluation of penicillin allergy in pregnant patients is encouraged by obstetrical societies, though historically allergy testing during pregnancy has not been widely performed. Numerous recent studies have reported positive outcomes for penicillin allergy testing in pregnancy through oral challenge with or without preceding skin testing for patients with low-risk history with few adverse reactions. Patients with high-risk histories such as anaphylaxis or severe delayed hypersensitivity are not candidates for testing; however, these represent the minority of patients.