Research Indicates Safe Penicillin Allergy Testing and Delabeling for Pregnant Women

Evaluating Penicillin Allergy in Pregnant Patients

Recent research presented at the 2026 AAAAI Annual Meeting sheds light on the importance of penicillin allergy evaluation in pregnant patients. This study highlights that delabeling patients who are incorrectly labeled as penicillin allergic can significantly reduce the use of alternative antibiotics, which often come with elevated risks during pregnancy.

Dr. Divya L. Jasthi, the primary author of the study, emphasizes the crucial nature of this issue, stating, "Beta-lactam allergy labels in pregnancy lead to the unnecessary prescription of alternative antibiotics that carry risks of adverse outcomes. Evaluating and potentially removing these labels is critical for both patient safety and effective treatment."

The retrospective study took place at a single medical center and focused on patients in their third trimester who were referred for penicillin allergy testing from June 2023 to August 2025. Through descriptive analysis and chi-squared testing, researchers investigated the methods employed for allergy delabeling and their impact on antibiotic choices during delivery.

Out of 111 patients referred for evaluation, 58 underwent testing—39 through a specific 10/90 challenge, while others received a skin test followed by a full-dose challenge. Remarkably, only one patient tested positive for a skin allergy, while two experienced reactions to an amoxicillin challenge, despite earlier negative skin tests. A notable finding was that all participants who underwent the 10/90 challenge passed without adverse effects.

Among those who delivered, 71 patients participated in the study, with 35 receiving penicillin evaluation. Importantly, among 13 patients who tested positive for Group B Streptococcus (GBS), only eight underwent allergy evaluation. Consequently, the absence of testing was correlated with a higher rate of unnecessary alternative antibiotic use during delivery for those GBS-positive patients, illustrating the potential risks of not addressing allergy labels appropriately.

The study also highlights the inadequacy of skin testing in predicting potential reactions, advocating for more direct oral challenges as a superior method for testing in pregnant patients. This shift in approach could lead to improved outcomes for both mothers and newborns, as currently available methodologies may not sufficiently assess the safety of antibiotic use in this sensitive population.

Looking ahead, the researchers call for further studies to explore the outcomes related to various testing techniques to optimize patient care. Such initiatives are essential as the medical community grapples with ensuring safe and effective treatment options for pregnant women.

In conclusion, this study indicates that evaluating and potentially delabeling penicillin allergies in pregnant patients is both necessary and safe. The ongoing investigation into these procedural methods serves as a reminder of how critical it is to re-evaluate practices based on emerging research, ensuring better health outcomes for those who are expectant mothers.

For more information about penicillin allergies and ongoing research, visit aaaai.org.