Clindamycin-associated acute generalized exanthematous pustulosis

Croy, C.; Buehrle, K.; Szwak, Jennifer Austin

doi:10.1111/jcpt.12528

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Other Hypersensitivity Reactions Other immunologic drug reactions that have been reported include fixed drug eruptions [42]. Other rare hypersensitivity reactions to clindamycin include DRESS/DiHS [43][44][45], SDRIFE [46], AGEP [47][48][49][50][51][52][53], and acute febrile neutrophilic dermatosis or Sweet Syndrome [54][55][56]. DRESS is a rare delayed hypersensitivity reaction often occurring 2-8 weeks from drug exposure and characterized by skin eruption, fever, eosinophilia, lymphadenopathy, and internal organ (i.e., liver, kidney, lung) involvement [43][44][45].…”

Section: Ige-mediated Reactionsmentioning

confidence: 99%

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Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

Dilley

Geng

2021

Clinic Rev Allerg Immunol

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Hypersensitivity reactions including IgE-mediated and delayed cell-mediated reactions to aminoglycosides, clindamycin, linezolid, and metronidazole are rare. For aminoglycosides, allergic contact dermatitis is the most frequent reaction for which patch testing can be a useful step in evaluation. For clindamycin, delayed maculopapular exanthems are the most common reactions. There are case reports of clindamycin associated with drug rash with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), acute febrile neutrophilic dermatosis, and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). For linezolid, cases of hypersensitivity were exceedingly rare and included urticaria, angioedema, anaphylaxis, delayed rashes, and DRESS. For metronidazole, only rare cases were found across a broad spectrum of reactions including allergic contact dermatitis, fixed drug eruption, angioedema, anaphylaxis, serum sickness-like reaction, SJS/TEN, AGEP, SDRIFE, and a possible case of DRESS. IgE-mediated reactions and anaphylaxis to these types of antibiotics are uncommon, and reports of skin testing concentrations and desensitization protocols are largely limited to case reports and series. Non-irritating skin testing concentrations have been reported for gentamycin, tobramycin, and clindamycin. Published desensitization protocols for intravenous and inhaled tobramycin, oral clindamycin, intravenous linezolid, and oral and intravenous metronidazole have also been reported and are reviewed.

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Section: Ige-mediated Reactionsmentioning

confidence: 99%

“…Historically, AGEP has rarely been associated with clindamycin. There have been increasing numbers of case reports of AGEP with clindamycin in the recent literature [47][48][49][50][51][52][53].…”

Section: Ige-mediated Reactionsmentioning

confidence: 99%

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

Dilley

Geng

2021

Clinic Rev Allerg Immunol

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“…Acute generalized exanthematous pustulosis was the most prevalent adverse event of clindamycin. Facial skin and oral mucosa were always reported as the initial site of such a lesion (Croy, Buehrle, & Austin Szwak, 2017; Karakayali et al., 2017; Sampson, Klinkova, Vitko, & Casanas, 2018), some of which sometimes occurred only in oral‐maxillofacial system (Nitta et al., 2019). Additionally, other severe cutaneous lesions attacking oral‐maxillofacial part were also investigated, such as drug reaction with eosinophilia and systemic symptoms (Miller Quidley, Bookstaver, Gainey, & Gainey, 2012; Tian, Mohan, & Stallings, 2010), hypersensitivity syndrome (Nakamura, Watamatsu, & Muto, 2013; Papakonstantinou et al., 2018), and sweet syndrome (Kandula, Burke, & Goldfarb, 2010).…”

Section: Oral‐maxillofacial Adverse Events Related To Antimlarialsmentioning

confidence: 99%

Oral‐maxillofacial adverse events related to antimalarials

Wang

Jiang

et al. 2020

Oral Diseases

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Malaria is a worldwide parasitic disease, which affects millions of lives every year. Various medications are recommended by WHO for prevention and treatment of malaria. However, adverse events caused by antimalarials were frequently reported, some of which were severe and fatal. Disorders of many organs related to antimalarials have been well recognized, whereas few studies concentrated on the relationship between antimalarials and oral‐maxillofacial system health. Current review generalized the relevance of antimalarials to the health of oral‐maxillofacial part and raised an urgent need to form a standard management for antimalarial‐related oral‐maxillofacial adverse events.

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“…(1) Clindamycin-associated AGEP should in suspected in patients presenting with erythema followed by papules and pustules within 1 −3 weeks of clindamycin use [1,2]. (2) AGEP is self-limited and treatment involves discontinuation of clindamycin and supportive therapy with corticosteroids, antihistamines or antibiotics [2].…”

Section: Teaching Pointsmentioning

confidence: 99%

Acute generalized exanthematous pustulosis: a rare side effect of clindamycin

Basnet

Dhital

Tharu

2019

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: Acute generalized exanthematous pustulosis (AGEP) is a rare adverse effect of clindamycin characterized by widespread papules and pustulosis 1-3 weeks of its use. Case description: We present a case of a 71-year-old woman diagnosed with AGEP after clindamycin use for a tooth infection. She had been started on empiric prednisone without benefit. She did not have any systemic involvement and had an unremarkable blood work. Her rash resolved completely in a month.

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Clindamycin-associated acute generalized exanthematous pustulosis

Abstract: Timely management of adverse skin reactions to antibiotics is paramount, and early identification of the culprit agent can allow for an alternative agent to be utilized. Clindamycin should be considered a potential causative agent for patients with skin reactions.

Cited by 9 publications

References 9 publications

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole

Oral‐maxillofacial adverse events related to antimalarials

Acute generalized exanthematous pustulosis: a rare side effect of clindamycin

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