title: Clindamycin skin testing has limited diagnostic potential.
abstract: We examined the role of clindamycin prick and intradermal skin testing in a tertiary care clinic population. Experience with diagnostic modalities such as prick and intradermal testing has been limited with clindamycin. A retrospective chart review was conducted for patients with immunologic reactions temporally associated with clindamycin who were referred to the Drug Safety Clinic (Toronto, Ontario). A total of 31 patients were identified who had undergone prick and intradermal skin testing. All 31 negative immediate prick and intradermal tests were followed by a 150 mg oral dose of clindamycin. 10/31 (32%) subjects had significant reactions to the oral clindamycin provocation. 2 patients reported delayed reactions at the clindamycin intradermal test sites. Our experience suggests that prick and intradermal skin testing is not adequate in identifying patients with previous allergic reactions associated with clindamycin. Oral provocation tests can be used in patients with histories of clindamycin adverse reactions; however, it should be offered on a risk-benefit basis.
authors.affiliation: Drug Safety Clinic, Division of Clinical Pharmacology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Notman
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Phillips
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Knowles
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Weber
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002981:Clindamycin / Q000009:adverse effects*; D003875:Drug Eruptions / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012882:Skin Tests
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin