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克林霉素的皮肤不良反应:皮肤试验和口服暴露的结果

Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure.

作者信息

Lammintausta K, Tokola R, Kalimo K

机构信息

Department of Dermatology, Turku University Central Hospital, 20520 Turku, Finland.

出版信息

Br J Dermatol. 2002 Apr;146(4):643-8. doi: 10.1046/j.1365-2133.2002.04665.x.

Abstract

BACKGROUND

Clindamycin is an antibiotic used in anaerobic and severe complicated infections. It is often selected for patients with a history of allergy to other antibiotics.

OBJECTIVES

To study the occurrence of clindamycin hypersensitivity and to determine whether skin tests are useful in cases of suspected clindamycin allergy.

METHODS

Six patients with an exanthematous rash and a history strongly suggestive of clindamycin hypersensitivity were studied with skin tests and oral exposure. Cases of suspected adverse drug reactions to clindamycin reported to the National Register of Adverse Effects of Drugs (NRAED) in Finland during 1973-2000 were analysed.

RESULTS

In the skin tests true-positive patch test reactions were seen in four of six patients, while 22 healthy control patients were negative. One false-positive and one false-negative patch test reaction were seen. During 1973-2000, 29 suspected cases of skin and/or mucosal membranes affected by clindamycin were reported to the NRAED.

CONCLUSIONS

Clindamycin hypersensitivity is not common. Delayed-type allergic reactions occur and patch tests are useful in those cases. Oral exposure is the method of choice if possible, as false-negative and false-positive reactions may occur.

摘要

背景

克林霉素是一种用于治疗厌氧菌感染和严重复杂感染的抗生素。对于有其他抗生素过敏史的患者,常选用克林霉素。

目的

研究克林霉素过敏反应的发生率,并确定皮肤试验在疑似克林霉素过敏病例中是否有用。

方法

对6例有皮疹且有强烈克林霉素过敏史的患者进行皮肤试验和口服暴露试验。分析了1973 - 2000年期间向芬兰国家药物不良反应登记处(NRAED)报告的疑似克林霉素药物不良反应病例。

结果

在皮肤试验中,6例患者中有4例出现真阳性斑贴试验反应,而22例健康对照患者为阴性。观察到1例假阳性和1例假阴性斑贴试验反应。1973 - 2000年期间,NRAED报告了29例疑似受克林霉素影响的皮肤和/或黏膜病例。

结论

克林霉素过敏并不常见。会发生迟发型过敏反应,斑贴试验在这些病例中有用。如果可能,口服暴露是首选方法,因为可能会出现假阴性和假阳性反应。

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