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Clindamycin hypersensitivity appears to be rare.
N Mazur1, P A Greenberger, J Regalado
1Ernest S Bazley Asthma and Allergic Diseases Center of the Department of Medicine, Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Illinois, USA.
Summary
Adverse drug reactions to clindamycin are less common than previously thought, with an incidence below 1%. A case study highlights a patient with a confirmed clindamycin hypersensitivity, emphasizing careful drug allergy assessment.
Area of Science:
- Clinical Pharmacology
- Pharmacovigilance
- Drug Hypersensitivity
Background:
- Previous literature suggested a high incidence (10%) of cutaneous eruptions associated with clindamycin.
- A patient presented with a generalized erythematous papular rash following preoperative clindamycin administration.
Observation:
- A 50-year-old patient developed a worsening rash post-clindamycin, which resolved with hydrocortisone.
- Skin tests for clindamycin hypersensitivity were negative in this patient.
- A patient with a history of cephalosporin allergy was identified as clindamycin-allergic after a preoperative dose.
Findings:
- The incidence of hospital-wide adverse drug reactions to clindamycin between 1995 and 1997 was determined to be 0.47% (14 out of 3,896 administrations).
- A significant proportion of reported reactions (7 out of 14) were confounded by concurrent medication use.
- The study concludes that adverse drug reactions to clindamycin are considerably lower than historical estimates, with an incidence below 1%.
Implications:
- The actual incidence of clindamycin-induced adverse drug reactions is significantly lower than previously reported.
- Accurate assessment of drug allergies is crucial, as demonstrated by the patient with a confirmed clindamycin hypersensitivity despite a prior cephalosporin allergy diagnosis.
- This data supports a re-evaluation of clindamycin's safety profile and may influence prescribing practices.