Widely used class of antibodies which act by inhibiting bacterial protein synthesis.
Uncommon (0.5 to 2.3% of treatments) for skin reactions.
Exceptional for anaphylaxis and acute respiratory failure.
Asthma (spiramycin ++).
Fixed drug eruption (erythromycin), urticaria, maculopapular rash, vasculitis (rare), contact dermatitis.
Urticaria, vasculitis, fixed drug eruption and thrombocytopenic
purpura recently described with clarithromycin.
Cutaneous testing: usually negative with erythromycin. One case with positive skin prick-tests (erythromycin lactobionate 10 mg/ ml)
Positive patch-tests in fixed drug eruption (skin lesions).
Specific IgE: usually negative. One case with erythromycin specific IgE (sepharose radioimmunoassay).
Leukocyte histamine release.
IgE-mediated hypersensitivity in few patients.
Cross-reactivity among macrolides has not been demonstrated.