Effectiveness and safety of algorithm for treating pregnant women with syphilis and history of immediate allergy to penicillin
Year: 2025
Type: article
Abstract: Background: Penicillin is the only proven effective treatment for pregnant women with syphilis. Objective: We evaluated the efficacy and safety of an algorithm to guide reexposure to penicillin in pregnant women with syphilis and a history of allergy to the drug; and identified predictive biomarkers for successful desensitization. Methods: By using risk stratification, pregnant women with syphilis and a history of immediate hypersensitivity reaction to penicillin were reexposed to the drug through rapid desensitization or drug provocation test. Patients with a high-risk clinical history for anaphylaxis or positive skin test result underwent desensitization. Results: > .0001). Seventy-eight patients (61.4%) considered to be at low risk were challenged, with only 3 (3.8%) experiencing a reaction. The risk stratification algorithm evaluated in this study demonstrated high efficacy (99.2%) and safety (92.1%) in guiding penicillin reintroduction. Conclusion: Our algorithm for managing immediate reactions to penicillin is effective and safe. Skin testing identifies patients at higher risk for reactions. This study enables the identification of pregnant women with a history of high risk for immediate hypersensitivity to penicillin, allowing for safe desensitization treatment, or can offer low-risk pregnant women the option to delabel the allergy through a provocation test.
Institution: Universidade de São Paulo
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W4414571685