Clindamycin Reaction?

[Lenore989]

For the last week I have had a severe rash on my face, neck, chest and back that comes and goes.  It is worst in the morning and evening, after I shower - or when I become stressed/anxious - this is when white heads appear on many of the red bumps.  It itches and at times makes my skin feel "crawly."  This began 5 days after taking Clindamycin for a staph infection (caused by a bug bite).  (The day before taking the Clindamycin I had been on Nitrofuroin for a UTI.  In affect, I had been on antibiotics for about 2-3 weeks before my skin errupted.)  The doctor took me off Clindamycin at the onset of the rash, and prescribed an oral steroid.  I took that for 1.5 days (3 pills).  I was supposed to take 5 days worth, but the rash had completely disappeared.  Now that I'm off the steroids, just a day and a half later the rash is returning - and quickly.  Can anyone tell me anything about this?  The doctor I saw for the staph infection is sending me to a dermatologist, but I've never had skin issues before.  I think it's some kind of real medical problem or allergic reaction.  

[Rowena Santos, MD]

Hi,

Clindamycin is a lincosamide antibiotic which is used to treat infections with anaerobic bacteria, some protozoal diseases, acne, and against some methicillin-resistant Staphylococcus aureus (MRSA) infections.  Common adverse drug reactions may include: diarrhea, pseudomembranous colitis, nausea, vomiting, abdominal pain or cramps, rash, and itch. Topical application may also cause contact dermatitis. In your case, the rash could be due to the medication or from other causes.

It is best that you see your dermatologist for further evaluation. A complete medical history and physical examination of the rash/lesions is important to determine t he diagnosis. An allergic reaction usually resolves  after the offending trigger ( either food, medication or other substances ) is removed.  

Take care and regards.

[Lenore989]

I visited a skin doctor this morning, who sais due to the pustules it is most likely bacterial and not due to allergies of any kind.  Is this accurate information?  He has put me back on steroids for the next week and I am to see him in 10 days.  In the meantime, I may schedule an appt with an allergist.  Recommended?

[Rowena Santos, MD]

Hi,

How are you? You should continue with your medication as prescribed by your doctor. Since the rash responds well to the steroid, this could indeed be bacterial in nature.  You can always go to the allergy specialist to completely rule out alllergic reaction and alleviate your worries. But it is important that you go back for your follow up appointment with your dermatologist.

Take care and do keep us posted.

[Zaba164]

FYI, NEVER stop your medication just because the visible rash or infection or whatever symptom has gone away. Always take the full course. See an internal medicine doctor and not a dermatologist for better informed results.