Antibiotic Treatment for Dental Abscess in Pregnant Patients with Penicillin Allergy

Assessment of Penicillin Allergy Severity

Severe allergy indicators include history of anaphylaxis, angioedema, respiratory distress, or urticaria following penicillin or cephalosporin exposure, as recommended by the Centers for Disease Control and Prevention, based on guidelines from MMWR Recommendations and Reports 1
Patients with non-severe reactions may safely receive cephalosporins like cefazolin, according to the American Academy of Allergy, Asthma, and Immunology, as cited in MMWR Recommendations and Reports 1

Azithromycin is compatible with pregnancy and may be used as an alternative macrolide with better tolerability than erythromycin, as stated by the American College of Obstetricians and Gynecologists, based on guidelines from Praxis Medical Insights: Practical Summaries of Clinical Guidelines 4

The treatment algorithm involves assessing allergy severity and selecting an antibiotic, with clindamycin as the first choice, azithromycin as the second choice, and erythromycin as the third choice, according to the Infectious Diseases Society of America, based on guidelines from MMWR Recommendations and Reports 1