Beta-Lactam Allergy Delabeling Safe for Pregnant Patients

Evaluation of penicillin allergy labels in pregnancy reduces beta-lactam alternative antibiotic use in GBS-positive patients

MILWAUKEE, Feb. 12, 2026 /PRNewswire/ -- Penicillin allergy evaluation and subsequent delabeling reduces unnecessary alternative antibiotic use and is safe for pregnant patients, according to new research being presented at the 2026 AAAAI Annual Meeting.

"Beta-lactam allergy labels in pregnancy lead to use of alternative antibiotics that are associated with increased risk of adverse outcomes. Therefore, it is important to evaluate methods of beta-lactam allergy testing in pregnancy and their safety. This research suggests that beta-lactam allergy evaluation in pregnancy reduces alternative antibiotic use," said Divya L. Jasthi, MD, MPH, primary author of the study.

In this single-center retrospective study, researchers examined third trimester pregnant patients referred for penicillin allergy testing from June 2023 to August 2025. To assess methods and outcomes of allergy delabeling, researchers used descriptive analysis and chi-squared analysis to understand the association between testing and alternative antibiotic use.

Among the 111 patients referred for penicillin allergy evaluation, 58 underwent evaluation, 39 of which were through 10/90 challenges, and 19 received penicillin skin testing followed by a full-dose challenge. Only one patient had a positive skin test, while two participants reacted to an amoxicillin challenge despite having a negative skin test. All patients who underwent 10/90 challenges passed, and, among 71 deliveries, 35 patients had penicillin evaluation. Of the 13 GBS-positive patients, only eight underwent penicillin allergy evaluation, leaving five unevaluated. Three patients who did not undergo evaluation received beta-lactam alternative antibiotics during delivery, and researchers noted that an absence of penicillin allergy evaluation was significantly associated with receiving alternative antibiotics in GBS-positive patients (X2 = 6.24, p =0.0125).

The researchers suggested that direct oral challenges in pregnancy should be increasingly considered as penicillin skin testing in the study did not predict reactions in some of the participants. Future study is encouraged toward evaluating outcomes with different testing methodologies to better understand patient care outcomes.

Visit aaaai.org to learn more about penicillin allergy. Research presented at the 2026 AAAAI Annual Meeting, February 27 – March 2 in Philadelphia, PA, is published in an online supplement to The Journal of Allergy and Clinical Immunology (JACI).

The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.

SOURCE American Academy of Allergy, Asthma & Immunology (AAAAI)