This algorithm can be used to:
When delabeling strategies are being considered (e.g. Skin Testing or Direct Challenge), the pathway will provide practical guidance on these procedures
When to NOT Use this Tool
Pregnancy does not alter the likelihood of reacting or cross-reacting to a beta-lactam
Most experts agree that pregnant patients should NOT be treated differently, especially when:
Most clinicians use caution in Type I immediate reactions when considering the offending agent, and are generally uncomfortable challenging pregnant patients without testing
Ideally, if skin testing is indicated, this should be performed by an allergist or someone with experience
Evidence regarding Direct Challenges in pregnancy is lacking; most agree that it can be done in patients with low risk histories
Use the algorithm for any applicable specific guidance in pregnant patients
While most experts agree that the information in this pathway can be applied to kids, particularly the cross-reactivity assessment, detailed guidance pertaining to allergy management and delabeling in pediatrics will be updated upon completion of the allergy initiative led by Dr. Jennifer Balfour
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