Perioperative intravenous clindamycin anaphylaxis following cutaneous acne gel sensitization

Abstract

AbstractWe describe perioperative anaphylaxis following intravenous clindamycin in two healthy adolescent patients with prior transcutaneous clindamycin sensitization. Prior to their third molar extractions, both patients were only previously exposed to clindamycin via topical acne gels, which primed their immune system for the observed response. Cognizance of the classic signs of anaphylaxis is paramount so that any procedure or infusion can be halted immediately, and the condition treated appropriately. We anticipate the frequency of such reactions to increase, particularly among adolescents, given the frequency of clindamycin use in oral and maxillofacial surgical procedures, the prevalence of third molar extractions among the paediatric population, and the widespread topical antibiotic use in acne treatments that can sensitize the immune system for anaphylaxis upon internal antigen reintroduction.