ArticleThe World Allergy Organization journal2021
Algorithm to guide re-exposure to penicillin in allergic pregnant women with syphilis: Efficacy and safety.
Article in The World Allergy Organization journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- The cost-effectiveness of syphilis screening in pregnant women: a systematic literature review.Frontiers in public health · 2024Pooled it
- Rapid food desensitization supported by omalizumab, with adjunctive dupilumab for type 2 comorbidities: A pediatric case series.The World Allergy Organization journal · 2026Article
- Successful desensitization to liposomal amphotericin B for the treatment of disseminated cryptococcosis in pregnancy: a case report.ASM case reports · 2026Article
- Effectiveness and safety of algorithm for treating pregnant women with syphilis and history of immediate allergy to penicillin.The journal of allergy and clinical immunology. Global · 2025Article
- Rapid food desensitization associated with omalizumab before oral immunotherapy.The World Allergy Organization journal · 2025Article
- Oxaliplatin desensitization for ovarianGynecologic oncology reports · 2024Article
- Novel approach to idursulfase and laronidase desensitization in type 2 and type 1 S mucopolysaccharidosis (MPS).Orphanet journal of rare diseases · 2022Article
- Analysis of serological treatment response to doxycycline versus benzathine penicillin in syphilis infections, a retrospective single-center study.Dermatologic therapy · 2022Article
- Stochastic Petri net model describing the relationship between reported maternal and congenital syphilis cases in Brazil.BMC medical informatics and decision making · 2022Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGestational syphilis is underdiagnosed and undertreated, leading to stillbirth, prematurity, low birthweight, neonatal death, and congenital syphilis. Most patients who label as allergic to penicillin are misdiagnosed.
objectiveTo assess the efficacy and safety of an algorithm to guide re-exposure to penicillin in pregnant women with syphilis and reporting allergy to the antibiotic.
methodsWe performed a prospective study assessing pregnant women with syphilis and labeled as allergic to penicillin. Based on clinical history, patients were divided in two groups: high-risk and low-risk to penicillin allergy. Low-risk patients with negative skin testing and negative serum specific IgE to penicillin underwent drug provocation test. The remaining patients underwent desensitization.
resultsNinety-one patients were enrolled. Allergy to penicillin was confirmed in 7.69% of pregnant women with syphilis and clinical history of allergy to penicillin; in all cases the diagnosis was made through intradermal testing, which predicted 100% of the breakthrough reactions observed during rapid drug desensitization (p < 0.001). Risk stratification based on the initial clinical reaction and skin testing to guide penicillin re-introduction through drug challenge or desensitization was safe (97.8%) and effective (97.8%).
conclusionWe developed and showed the efficacy and safety of an algorithm to guide re-exposure to penicillin in pregnant women with syphilis and labeled as allergic to this drug. Intradermal test is an excellent biomarker in the diagnosis of immediate hypersensitivity reaction to penicillin and to predict breakthrough reaction during rapid drug desensitization. Further studies may confirm the greater safety of the intravenous protocol compared to the oral protocol.
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