Elena Resnick
speaker
130 appearances
2 recordings
1 series
first heard Jan 2025
last heard 17 Jul
Elena Resnick’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.
Appearances
If it's negative, we go on and do the intradermal test, which hurts a little bit more. We're using the same reagents, and we're putting them just under the surface of the skin. And again, we look to see, do those bumps get any bigger during the waiting period? And we're comparing them again against saline. If that test is positive, again, you go home. That's it. You're allergic.
But if that test is negative, we now have a skin prick and intradermal tests that are both negative. And the studies show that in those cases, it's 95% likely that you'll then pass a penicillin challenge. I think in real life, it's probably much, much higher than that. But we go ahead and we do an oral challenge, which is just what it sounds. We give you a dose of a penicillin.
We use amoxicillin, which is a common oral penicillin. We give you that dose. We have you wait in the office for about two hours just to make sure that you're fine. And that's the gold standard, right? Tests are tests. But if you take the medication and you're fine, then we know you're not allergic.
Atenosylins are an amazing drug also because we know them to be safe and effective in pregnancy. When a pregnant woman goes in to deliver, if she is colonized with group B strep, which is a very common vaginal infection, she must be given antibiotics before delivery to ensure that the baby is not exposed to the group B strep.
So the antibiotic of choice for group B strep is in the penicillin family. Mom comes in. She's ready to deliver. She gets a dose of penicillin. She gets her second dose four hours later. She delivers the baby. Everything is fine. If she is thought to be penicillin allergic, instead she's given vancomycin. Vancomycin dosing interval is every 12 hours.
So if she's not dosed appropriately, the baby can be considered inadequately treated, and that leads to all sorts of other complications. Potential decisions, maybe getting put on antibiotics, maybe going to the NICU. Again, the complications just from this penicillin label are intense. So in this particular scenario, this mom went in to deliver. She was thought to be penicillin allergic.
They gave her vancomycin. She developed Redman syndrome from the vancomycin, which is just what it sounds like, where the body is. becomes completely red and flushed and other medications have to be given. And then she had a wound infection from her C-section because she was still thought to be penicillin allergic.
They gave her clindamycin to treat the wound infection, and she developed C. diff from the clindamycin. And how did that play out? So when you develop C. diff, then you have to be put on oral vancomycin and then treated usually for two weeks. It's just a nightmare. It's one thing after another. And then she came to see me and we were able to clear her of that penicillin allergy.
So her OBGYN, we also rely on the OBGYNs to find people who in their charts have this penicillin allergy. The problem with that is we're not going to test a pregnant woman just on the off chance that she does end up being one of these rare people who's truly allergic. Obviously, we don't want to put a pregnant woman into anaphylaxis.
So we're sort of stuck with that label, which is hard for the OB because then their patient gets a simple infection. They can't use a penicillin. So a lot of the OBs will say to their patients, before you get pregnant again, better go get cleared of your penicillin allergy.
Showing 121–130 of 130 · page 7 of 7
← Previous