Clindamycin hypersensitivity appears to be rare

Background: A patient developed a generalized confluent erythematous papula r rash after a single injection of clindamycin preoperatively. The literatu re from two small studies suggested a 10% incidence of cutaneous eruptions to clindamycin which seemed toe high. Objective: Describe a patient with clindamycin hypersensitivity and determi ne the incidence of hospital-wide adverse drug reactions from clindamycin f rom 1995-1997. Methods: At a tertiary care center, utilizing the Department of Pharmacy re cords, the incidence of adverse drug reactions was determined with (1) volu ntary physician reporting, (2) Health Information Management chart reviews and adverse drug reaction coding, and (3) chart reviews by the Pharmacy and Therapeutics Committee of adverse drug reactions, Results: (1) A 50-year-old patient developed a generalized raised, erythema tous rash that worsened over 3.5 days until hydrocortisone was administered . Immediate skin tests with clindamycin were negative. (2) From 3,896 admin istrations of clindamycin from April 1995 to October 1997, 14 (0.47%) adver se drug reactions occurred but 7 were confounded by other medications also being administered. Conclusion: (1) Adverse drug reactions to clindamycin are much lower than r eported 25 years ago with an incidence <1%. (2) A patient who previously ha d experienced facial edema and a generalized rash after receiving clindamyc in and a cephalosporin 6 years ago and who was considered allergic to cepha losporins, was found to be clindamycin allergic when she received a preoper ative dose of clindamycin.