Penicillin-allergic Pregnant Women with Syphilis: Flow of Management at Siriraj Hospital
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Published:
Oct 1, 2021
Keywords:
ซิฟิลิส หญิงตั้งครรภ์ แพ้ยาเพนิซิลลิน Penicillin desensitization
Main Article Content
Abstract
Penicillin has been evidently the mainstay antibiotic for treating pregnant women with syphilis to eliminate congenital syphilis. One of the biggest challenges for obstetricians is that a number of patients report penicillin allergy. Penicillin desensitization has been recommended by many academic organizations, including the Center for Disease Control and Prevention. The procedure requires well-trained multidisciplinary care team which includes obstetricians, allergists, anesthesiologist, pharmacists and experienced nurses. The venue of desensitization should ideally be an intensive care unit where emergency resuscitation is always available. This article aims to demonstrate a model of management at Siriraj Hospital.
Article Details
How to Cite
1.
Wongsa C, Sompornrattanaphan M, Chayachinda C, Swasdimongkol P, Thongngarm T. Penicillin-allergic Pregnant Women with Syphilis: Flow of Management at Siriraj Hospital . Siriraj Med Bull [Internet]. 2021 Oct. 1 [cited 2024 Apr. 29];14(4):62-73. Available from: https://he02.tci-thaijo.org/index.php/simedbull/article/view/251525
Section
Review Article
References
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24. Dalle J, Ramos MC, Jimenez MF, Escobar FG, Antonello VS. Oral Desensitization to Penicillin for the Treatment of Pregnant Women with Syphilis: A Successful Program. Rev Bras Ginecol Obstet. 2018;40(1):43-6.
25. Broderick MP, Hansen CJ, Russell KL, Kaplan EL, Blumer JL, Faix DJ. Serum Penicillin G Levels Are Lower Than Expected in Adults within Two Weeks of Administration of 1.2 Million Units. PLoS ONE 2011; 6: e25308.
26. Simons FE, Schatz M. Anaphylaxis during pregnancy. J Allergy Clin Immunol. 2012;130(3):597-606.
27. Liew ZQ, Ly V, Olson-Chen C. An old disease on the rise: new approaches to syphilis in pregnancy. Curr Opin Obstet Gynecol. 2020;Publish Ahead of Print.
28. คณะทำงานเพื่อการรักษาและป้องกันการแพ้ชนิดรุนแรงแห่งประเทศไทย. แนวทางเวชปฎิบัติสำหรับการดูแลผู้ป่วยที่มีการแพ้ชนิดรุนแรง พ.ศ. 2560. [cited 2020 Nov 11]. Available from: URL: http://allergy.or.th/2016/pdf/Thai_CPG_Anaphylaxis_2017_Full_version.pdf
2. Rungmaitree S, Mokkhamakkun C, Phongsamart W, Lolekha R, Wittawatmongkol O, Lapphra K, et al. Incidence of and factors associated with congenital syphilis at a tertiary hospital in bangkok, Thailand. Southeast Asian Journal of Tropical Medicine and Public Health. 2019;50(6):1-12.
3. Chayachinda C, Chinhiran K, Chaithongwongwatthana S, Kittiyaowamarn R, Thamkhantho M. Elimination of congenital syphilis: What’s new for obstetricians in the 2020 Thai National Guideline? Thai Journal of Obstetrics and Gynaecology. 2021;29(1):2-9.
4. Janier M, Hegyi V, Dupin N, Unemo M, Tiplica G, Potocnik M, et al. 2014 European guideline on the management of syphilis. J Eur Acad Dermatol Venereol. 2014;28(12):1581-93.
5. World Health Orgaization. WHO guidelines for the treatment of Treponema pallidum (syphilis)2016 1 September 2020 Available from: https://apps.who.int/iris/bitstream/handle/10665/249572/9789241549806-eng.pdf;jsessionid=E4EBFE6D87B56B19990EDBDD174029DA?sequence=1.
6. Nathan L, Bawdon R, Sidawi J, Stettler R, McIntire D, Wendel GJ. Penicillin levels following the administration of benzathine penicillin G in pregnancy. Obstet Gynecol. 1993;82:338-42.
7. Zhu L, Qin M, Du L, Xie R, Wong T, Wen S. Maternal and congenital syphilis in Shanghai, China, 2002 to 2006. International Journal if Infectious Diseases. 2010;14S:e45-e8.
8. Clement M, Okeke N, Hicks C. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905-17.
9. Liu H, Han Y, Chen X, Bai L, Guo S, Li L, et al. Comparison of efficacy of treatments for early syphilis: a systematic review and network meta-analysis of randomized controlled trials and observational studies. PLoS One. 2017.
10. Castells M. Desensitization for drug allergy. Curr Opin Allergy Clin Immunol. 2006;6(6):476-81.
11. Gonzalez-Estrada A, Radojicic C. Penicillin allergy: a practical guide for clinicians. Cleve Clin J Med. 2015;82:295-300.
12. Blumenthal K, Shenoy E, Varughese C, Hurwitz S, Hooper D, Banerji A. Impact of a clinical guideline for prescribing antibiotics to inpatients reporting penicillin or cephalosporin allergy. Ann Allergy Asthma Immunol. 2015;115:294-300.e2.
13. Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014;133:790-6.
14. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International Consensus on drug allergy. Allergy. 2014;69(4):420-37.
15. Romano A, Atanaskovic-Markovic M, Barbaud A, Bircher AJ, Brockow K, Caubet JC, et al. Towards a more precise diagnosis of hypersensitivity to beta-lactams - an EAACI position paper. Allergy. 2020;75(6):1300-15.
16. Cernadas JR, Brockow K, Romano A, Aberer W, Torres MJ, Bircher A, et al. General considerations on rapid desensitization for drug hypersensitivity - a consensus statement. Allergy. 2010;65(11):1357-66.
17. Pham MN, Ho HE, Desai M. Penicillin desensitization: Treatment of syphilis in pregnancy in penicillin-allergic patients. Ann Allergy Asthma Immunol. 2017;118(5):537-41.
18. Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J. 2015;8(1):32.
19. Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review. JAMA. 2019;321(2):188-99.
20. Furness A, Kalicinsky C, Rosenfield L, Barber C, Poliquin V. Penicillin Skin Testing, Challenge, and Desensitization in Pregnancy: A Systematic Review. J Obstet Gynaecol Can. 2020;42(10):1254-61 e3.
21. Wu SS, Abraham T, Michaud C, Peppers B, Ward A, Buchner SE, et al. Fetal response to intramuscular epinephrine for anaphylaxis during maternal penicillin desensitization for secondary syphilis. J Matern Fetal Neonatal Med. 2018;31(16):2223-5.
22. Scherer K, Bircher AJ. Danger signs in drug hypersensitivity. Med Clin North Am. 2010;94(4):681-9, xv-x.
23. Broyles AD, Banerji A, Barmettler S, Biggs CM, Blumenthal K, Brennan PJ, et al. Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: Specific Drugs. J Allergy Clin Immunol Pract. 2020;8(9S):S16-S116.
24. Dalle J, Ramos MC, Jimenez MF, Escobar FG, Antonello VS. Oral Desensitization to Penicillin for the Treatment of Pregnant Women with Syphilis: A Successful Program. Rev Bras Ginecol Obstet. 2018;40(1):43-6.
25. Broderick MP, Hansen CJ, Russell KL, Kaplan EL, Blumer JL, Faix DJ. Serum Penicillin G Levels Are Lower Than Expected in Adults within Two Weeks of Administration of 1.2 Million Units. PLoS ONE 2011; 6: e25308.
26. Simons FE, Schatz M. Anaphylaxis during pregnancy. J Allergy Clin Immunol. 2012;130(3):597-606.
27. Liew ZQ, Ly V, Olson-Chen C. An old disease on the rise: new approaches to syphilis in pregnancy. Curr Opin Obstet Gynecol. 2020;Publish Ahead of Print.
28. คณะทำงานเพื่อการรักษาและป้องกันการแพ้ชนิดรุนแรงแห่งประเทศไทย. แนวทางเวชปฎิบัติสำหรับการดูแลผู้ป่วยที่มีการแพ้ชนิดรุนแรง พ.ศ. 2560. [cited 2020 Nov 11]. Available from: URL: http://allergy.or.th/2016/pdf/Thai_CPG_Anaphylaxis_2017_Full_version.pdf