antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»10.37489/0235-2990-2026-71-3-4-70-83TKVLEUantibiotics-1367Research ArticleОБЗОРЫREVIEWSВерификация аллергии на пенициллины в акушерстве как инструмент рациональной антибиотикотерапииVerification of Penicillin Allergy in Obstetric Practice as a Tool for Rational Antibiotic Therapyhttps://orcid.org/0000-0001-6270-583XЕникеевД.  А.EnikeevD. A.

Еникеев Дамир Ахметович — д. м. н., профессор

Уфа

Damir A. Enikeev — D. Sc. in Medicine, Professor

Ufa

maria.gri2001@gmail.comhttps://orcid.org/0009-0007-8520-7391Базалий М.  Г.BazaliyM. G.

Базалий Мария Григорьевна — врач-терапевт участковый

Архангельск

Maria G. Bazaliy — Therapist

Arkhangelsk

https://orcid.org/0009-0005-4436-6201Пилясова А.  Д.PilyasovaA. D.

Пилясова Анна Дмитриевна — студент

Москва

Anna D. Pilyasova — Student

Moscow

https://orcid.org/0009-0004-5427-6499ИгнатенкоА. И.IgnatenkoA. I.

Игнатенко Александр Иванович — студент

Москва

Alexandr I. Ignatenko — Student

Moscow

https://orcid.org/0009-0004-3111-6927ТоковаМ.  А.TokovaM. A.

Токова Мекка Абдуллаховна — студент

Москва

Mekka A. Tokova — Student

Moscow

https://orcid.org/0009-0002-9916-2853ПачеваА.  К.PachevaA. K.

Пачева Алина Касбулатовна — студент

Москва

Alina K. Pacheva — Student

Moscow

https://orcid.org/0009-0000-4969-6254НерсисянС.  К.NersisyanS. K.

Нерсисян Сюзанна Кареновна — студент

Москва

Suzanna K. Nersisyan — Student

Moscow

https://orcid.org/0009-0000-2085-9283АлександровЕ.  А.AleksandrovE. A.

Александров Егор Александрович — студент

Москва

Egor A. Alexandrov — Student

Moscow

https://orcid.org/0009-0005-7498-3622АнисимоваИ.  Р.AnisimovaI. R.

Анисимова Ирина Руслановна — студент

Москва

Irina R. Anisimova — Student

Moscow

https://orcid.org/0009-0006-8580-3014АлибековаТ. С.AlibekovaT. S.

Алибекова Тамила Сабировна — студент

Москва

Tamila S. Alibekova — Student

Moscow

https://orcid.org/0009-0003-8904-9379ЗаикинА. А.ZaikinA. A.

Заикин Артём Александрович — студент

Москва

Artem A. Zaikin — Student

Moscow

https://orcid.org/0009-0004-0577-0917КузнецоваЕ. А.KuznetsovaE. A.

Кузнецова Евгения Александровна — студент

Москва

Evgeniya A. Kuznetsova — Student

Moscow

https://orcid.org/0009-0008-1022-360XБурнышеваВ.  А. BurnyshevaV. A.

Бурнышева Вероника Андреевна — независимый исследователь

Veronika A. Burnysheva — Independent researcher

ФГБОУ ВО «Башкирский государственный медицинский университет»РоссияBashkir State Medical UniversityRussian FederationГБУЗ АО «Приморская центральная районная больница»РоссияPrimorsky Central District HospitalRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова»РоссияPirogov Russian National Research Medical UniversityRussian Federation202630042026713-47083Copyright © Еникеев Д.А., Базалий  М.Г., Пилясова  А.Д., Игнатенко А.И., Токова М.А., Пачева А.К., Нерсисян С.К., Александров Е.А., Анисимова И.Р., Алибекова Т.С., Заикин А.А., Кузнецова Е.А., Бурнышева В.А., 20262026Еникеев Д.А., Базалий  М.Г., Пилясова  А.Д., Игнатенко А.И., Токова М.А., Пачева А.К., Нерсисян С.К., Александров Е.А., Анисимова И.Р., Алибекова Т.С., Заикин А.А., Кузнецова Е.А., Бурнышева В.А.Enikeev D.A., Bazaliy M.G., Pilyasova A.D., Ignatenko A.I., Tokova M.A., Pacheva A.K., Nersisyan S.K., Aleksandrov E.A., Anisimova I.R., Alibekova T.S., Zaikin A.A., Kuznetsova E.A., Burnysheva V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.antibiotics-chemotherapy.ru/jour/article/view/1367

Аллергия на пенициллины является одной из наиболее часто регистрируемых лекарственных реакций у беременных, однако в большинстве случаев данный диагноз устанавливается на основании анамнеза без объективной верификации. В акушерской практике это имеет принципиальное значение, поскольку бета-лактамные антибиотики остаются препаратами первой линии для профилактики и лечения инфекций, включая интранатальную профилактику стрептококка группы B, антибиотикопрофилактику при кесаревом сечении и терапию сифилиса во время беременности. Неподтверждённая аллергия ограничивает применение оптимальных схем лечения, способствует назначению альтернативных препаратов широкого спектра действия и может быть связана с повышением риска инфекционных осложнений. В настоящем обзоре проанализированы современные данные о диагностике аллергии на пенициллины у беременных, включая кожное тестирование, пероральные провокационные пробы и инструменты стратификации риска. Представлены результаты клинических исследований, демонстрирующие высокую частоту снятия диагноза аллергии и благоприятный профиль безопасности обследования при правильном отборе пациенток. Рассмотрено влияние верификации аллергического анамнеза на структуру антибактериальной терапии и акушерские исходы. Верификация аллергии на пенициллины в рамках дородового наблюдения рассматривается как важный элемент рациональной антибиотикотерапии и антимикробной стратегии в акушерстве. Расширение практики целенаправленной диагностики позволяет повысить частоту назначения препаратов первой линии без ухудшения материнских и неонатальных показателей.

Penicillin allergy is one of the most frequently reported drug reactions among pregnant women; however, in most cases, the diagnosis is based solely on patient history without objective verification. In obstetric practice, this has substantial clinical implications, as β-lactam antibiotics remain first-line agents for the prevention and treatment of infections, including intrapartum prophylaxis for Group B Streptococcus, antibiotic prophylaxis during cesarean delivery, and treatment of syphilis in pregnancy. An unverified allergy label limits the use of optimal treatment regimens, promotes the prescription of broader-spectrum alternatives, and may be associated with an increased risk of infectious complications. This review analyzes current evidence on the evaluation of penicillin allergy in pregnant patients, including skin testing, direct oral challenges, and risk stratification tools. Clinical studies demonstrate a high rate of penicillin allergy de-labeling and a favorable safety profile of diagnostic procedures when appropriate patient selection is applied. The article also discusses the impact of allergy verification on antibiotic prescribing patterns and obstetric outcomes. Verification of penicillin allergy within routine prenatal care should be considered an essential component of rational antibiotic therapy and antimicrobial stewardship in obstetrics. Expanding targeted diagnostic strategies may increase the use of first-line β-lactam antibiotics without adversely affecting maternal or neonatal outcomes.

аллергия на пенициллиныбета-лактамные антибиотикибеременностькожное тестированиепероральная провокационная пробастратификация рискаантибиотикопрофилактикастрептококк группы Bрациональная антибиотикотерапияантимикробная настороженностьpenicillin allergybeta-lactam antibioticspregnancyskin testingoral challengerisk stratificationantibiotic prophylaxisGroup B Streptococcusrational antibiotic therapyantimicrobial stewardshipОтсутствуют.ReferencesПереверзев А.П., Зырянов С.К., Гущина Ю.Ш. Современные методы идентификации нежелательных явлений, вызванных ошибками применения лекарственных препаратов. Безопасность и риск фармакотерапии. 2016; (4): 11–16.Pereverzev AP, Zyryanov SK, Guschina YSh. Modern methods of identification of adverse events associated with medication errors. Safety and Risk of Pharmacotherapy. 2016; (4): 11–16. (In Russ.)Zhou L, Dhopeshwarkar N, Blumenthal KG, Goss F, Topaz M, Slight SP, Bates DW. 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The authors declare that there are no conflicts of interest present.