Can you take Clindamycin if allergic to Erythromycin? (ADR)

In this article, we will discuss whether it is safe to take Clindamycin if you’re allergic to erythromycin or not. Furthermore, we’ll explore the similarities and differences between these two antibiotics, the typical symptoms of an allergic reaction to Erythromycin and precautions and risks to consider.

Can you take Clindamycin if allergic to Erythromycin? 

Yes, you may take Clindamycin if allergic to Erythromycin. However, the right choice of antibiotic especially when you have a known allergy should be made by your healthcare provider. They will evaluate the nature and severity of your allergic reaction before determining whether Clindamycin or any other antibiotic is a safe alternative. (1)

Clindamycin and Erythromycin are both antibiotics, but they belong to different classes, such as Clindamycin belonging to the lincosamide class whereas Erythromycin belongs to the macrolide class of antibiotics. They both similarly exert their actions by inhibiting the bacterial protein synthesis which is essential for the growth and replication of bacteria, thus killing or inactivating the bacteria. (1,2)

Both these antibiotics are typically used to treat a broad range of bacterial infections including respiratory tract infections, UTIs, and skin and ear infections among others. The choice of antibiotic depends on the nature of the infection and individual response to medications. (1)

Being allergic to one does not necessarily mean you must be allergic to another too. However, cross-reactivity of allergies can occur, so it’s crucial to consult with your doctor before starting any new medication, especially when you have a known allergy. (2)

What does research suggest?

According to a research study, there is very limited evidence of cross-reactivity between Clindamycin and Erythromycin. Most of the researchers suggest that Clindamycin can be valuable in situations where there is resistance to Erythromycin. If bacteria are not responsive to Erythromycin, Clindamycin can serve as an effective alternative. (3)

The researchers further concluded that in cases where Erythromycin resistance is detected, a D-test is often recommended to check for induceable resistance to Clindamycin. This helps make sure that Clindamycin can be effective and not lead to treatment failure. (4)

This study shows that Clindamycin generally have a good safety profile but like any antibiotic, it can be associated with side effects. It’s crucial to consider individual patient factors and consult a doctor to determine the most appropriate antibiotic choice. (3)

How do Clindamycin and Erythromycin differ from each other?

Both Clindamycin and Erythromycin share some similarities in their mechanisms of action and some differences too, these are discussed in the table below: (1,2)

What are the symptoms of an allergic reaction to Erythromycin?

Some common symptoms of an allergic reaction to Erythromycin may include: (1,2)

Skinn reactions

• Rashes
• Itching or hives
• Swelling, particularly on the face, lips or tongue (angioedema)

Respiratory symptoms

• Difficulty breathing
• Wheezing
• Chest tightness

Gastrointestinal symptoms

• Nausea
• Vomiting
• Abdominal pain

Systemic symptoms

• Fever
• Malaise (general discomfort or feeling of uneasiness)
• Fatigue

In severe cases, an allergic reaction may progress to anaphylaxis which is an emergency condition. Anaphylaxis can lead to a rapid and life-threatening response that may include:

• Difficulty breathing due to airway constriction
• A sudden drop in blood pressure
• Rapid or weak pulse
• Loss of consciousness

Keep in mind that not all reactions to medications are allergic, some may be side effects or adverse reactions. 

How to safely use Clindamycin if allergic to Erythromycin?

If you’re allergic to erythromycin and need to take Clindamycin as an alternative, certain considerations and precautions must be taken thoroughly. (3)

Make sure to inform your doctor about your allergy to Erythromycin. They will consider this information when prescribing medications and may choose alternatives or adjust the dosage accordingly. Also, specify the nature and severity of your erythromycin allergy. (1)

If necessary, your doctor might recommend allergy testing to confirm our sensitivity and explore potential cross-reactivity with Clindamycin. This can help determine the safest course of action. 

Your doctor might also perform a D-test for induceable resistance, in cases where Clindamycin is being considered for bacterial infection where Erythromycin resistance is present. This will help ensure that Clindamycin will be effective in treating the infection. (4)

Take Clindamycin under the strict supervision of your doctor and adhere to the guidelines provided by your doctor regarding the dosage regimen, frequency of dosing and duration of course. Do not self-prescribe yourself nor alter the doses on your own. Also, check the expiry of Clindamycin before use to confirm the chemical integrity for appropriate therapeutic outcome. (1)

Summing up Erythromycin allergy and Clindamycin use as an alternative:

As a pharmacist, in my opinion, Clindamycin has shown significant therapeutic benefits in patients with allergies to Erythromycin. The majority of individuals taking Clindamycin as an alternative developed tolerance and a good safety profile with no complaints reported.

However, everyone is unique in terms of their brain chemistry and how they respond to medications, so it’s advisable to first consult your doctor and not self-prescribe yourself. Your doctor will weigh the risk-to-benefit ratio and tailor the treatment plan according to your specific health situation. 

References