J Allergy Clin Immunol

AAAAI 2026: Delabeling beta-lactam allergy in pregnancy found safe, reduces unnecessary antibiotic use

March 9, 2026

New research presented at the 2026 AAAAI Annual Meeting suggests that penicillin allergy evaluation and delabeling is safe in pregnancy and is associated with reduced use of alternative antibiotics. In a single‑center retrospective study of 111 third‑trimester patients, 58 completed evaluation—most through 10/90 oral challenges, all of which were tolerated—while only one skin test was positive and two patients reacted on amoxicillin challenge despite negative skin tests. Among 13 Group B strep‑positive patients, eight were evaluated and five were not; of those not evaluated, three (60%) required alternative antibiotics during delivery. Lack of evaluation was significantly associated with receiving alternative antibiotics, underscoring the clinical impact of delabeling.

Clinical takeaway: Consider direct oral penicillin challenges during pregnancy to safely remove inaccurate allergy labels and optimize intrapartum antibiotic therapy.

Source:

Jasthi D, et al. (2026, February). J Allergy Clin Immunol. Delabeling Beta-Lactam Allergy using Direct Oral Challenge in Pregnancy is Safe and Reduces Alternative Antibiotic Usage. https://www.jacionline.org/article/S0091-6749(25)02009-3/fulltext