Obstetric and Allergy Providers' Attitudes Towards Penicillin Allergy Testing in Pregnancy: A Single Hospital System Survey Study [ID: 1378292

Abstract

INTRODUCTION: Penicillin (PCN) allergy affects 10% of the U.S. population. The American College of Obstetricians and Gynecologists recommends PCN allergy testing in pregnancy when available. The objective of this study is to explore obstetric and allergy providers' knowledge and attitudes toward penicillin allergy testing and identify current barriers. METHODS: Single hospital system survey-based study of all obstetric and allergy providers. All obstetric and allergy providers were emailed an anonymous survey of their knowledge, current practice pattern, and perceived barriers to PCN allergy testing. Institutional review board approval was obtained for this study. RESULTS: From January 1, 2021 to July 31, 2022, 2,795 of 20,500 initial prenatal visits (14%) had a listed beta-lactam allergy. Of these 2,795 patients, 300 (11%) were referred for allergy testing. Fifty-four obstetric providers completed surveys. Thirty-nine percent of obstetric providers had never referred a patient for PCN allergy evaluation. Twenty-seven percent of obstetric providers self-identified lack of provider knowledge in testing process as a complete barrier to testing, and one-third of providers perceived lack of time in clinic to discuss referral as a barrier. Twenty-one allergy providers completed the survey. All allergy provider responders were willing to perform allergy testing in pregnant women, with 63% performing a direct oral challenge to confirm results. Forty-one percent of allergy providers preferred to defer testing until the third trimester. CONCLUSION: Allergy providers are willing and able to perform penicillin allergy testing in pregnancy, but testing is limited by obstetric provider referrals. Current barriers include obstetric provider knowledge about testing and resources to allow efficient discussion of testing benefits in clinic.