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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Syphilis in Pregnancy
Sponsored by The Indian Health Service Clinical Support Center
8. What about patients who are penicillin-allergic?
Since penicillin is the only adequate therapy for syphilis in pregnancy, women who have a history of allergy to penicillin should be skin-tested and desensitized. Only about 10 per cent of patients who report a history of penicillin allergy are actually allergic. The history is often based on childhood events reported second-hand, years after the supposed reaction, and frequently includes other non-allergic symptoms. Nevertheless, 3% or more of these patients will have had a serious reaction, defined as urticaria, angioedema, or anaphylaxis, after penicillin therapy, and could have a fatal reaction if re-exposed. Skin testing and desensitization in a monitored setting are therefore indicated. Details of these procedures can likewise be conveniently found in the “Sexually Transmitted Diseases Treatment Guidelines 2002” (Vol. 51, No.RR-6). pages 28-30.
