{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:03:06Z","timestamp":1790190186240,"version":"4.1.0"},"reference-count":134,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Macrolides are antimicrobial agents that can be used to treat a variety of infections. Allergic reactions to macrolides occur infrequently but can include minor to severe cutaneous reactions as well as systemic life-threatening reactions such as anaphylaxis. Most reports of allergic reactions occurred in patients without prior exposure to a macrolide. Cross-reactivity among macrolides may occur due to the similarities in their chemical structures; however, some published literature indicates that some patients can tolerate a different macrolide. Most published reports detailed an allergic reaction to erythromycin. Desensitization protocols to clarithromycin and azithromycin have been described in the literature. The purpose of this article is to summarize macrolide-associated allergic reactions reported in published literature. An extensive literature search was conducted to identify publications linking macrolides to hypersensitivity reactions.<\/jats:p>","DOI":"10.3390\/pharmacy7030135","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T11:01:15Z","timestamp":1568804475000},"page":"135","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Macrolide Allergic Reactions"],"prefix":"10.3390","volume":"7","author":[{"given":"Kristy M.","family":"Shaeer","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapeutics and Clinical Research, University of South Florida College of Pharmacy, Tampa, FL 33612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias B.","family":"Chahine","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL 33416, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheeba","family":"Varghese Gupta","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, University of South Florida College of Pharmacy, Tampa, FL 33612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, TX 75799, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(18)32218-9","article-title":"Antibiotic allergy","volume":"393","author":"Blumenthal","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1939-4551-6-18","article-title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy","volume":"6","author":"Thong","year":"2013","journal-title":"World Allergy Organ J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4168\/aair.2010.2.2.77","article-title":"Update on the management of antibiotic allergy","volume":"2","author":"Thong","year":"2010","journal-title":"Allergy Asthma Immunol Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2840","DOI":"10.2174\/138161208786369812","article-title":"Macrolides allergy","volume":"14","author":"Araujo","year":"2008","journal-title":"Curr. Pharm. Des."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2967","DOI":"10.1111\/bph.13936","article-title":"The macrolide antibiotic renaissance","volume":"174","author":"Dinos","year":"2017","journal-title":"Br. J. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/jac\/22.Supplement_B.13","article-title":"Mechanism of action of spiramycin and other macrolides","volume":"22","author":"Courvalin","year":"1988","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1155\/2015\/934594","article-title":"Fidaxomicin: A novel agent for the treatment of Clostridium difficile infection","volume":"26","author":"Zhanel","year":"2015","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jaip.2013.11.006","article-title":"Antibiotic allergies in children and adults: From clinical symptoms to skin testing diagnosis","volume":"2","author":"Romano","year":"2014","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_9","unstructured":"Mandell, G.L., Bennett, J.E., and Dolin, R. (2010). Macrolides. Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases, Churchill Livingstone\/Elsevier. [7th ed.]. Available online: http:\/\/web.a.ebscohost.com.ezproxy.lib.usf.edu\/ehost\/detail\/detail?vid=0&sid=ab19e82b-d5a8-4468-ab6a-243ed20974fa%40sdc-v-sessmgr04&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=458761&db=nlebk."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/cid\/cir625","article-title":"Pediatric Infectious Diseases, S. the Infectious Diseases Society of, A. Executive summary: The management of community-acquired pneumonia in infants and children older than 3 months of age: Clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e964","DOI":"10.1542\/peds.2012-3488","article-title":"The diagnosis and management of acute otitis media","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/cid\/cis847","article-title":"Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America","volume":"55","author":"Shulman","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"614","DOI":"10.4140\/TCP.n.2014.614.","article-title":"Fidaxomicin: A novel macrolide antibiotic for Clostridium difficile infection","volume":"29","author":"Chahine","year":"2014","journal-title":"Consult. Pharm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1093\/cid\/ciy149","article-title":"Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)","volume":"66","author":"McDonald","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.0105-1873.2004.0426d.x","article-title":"Occupational airborne allergic contact dermatitis from azithromycin","volume":"51","author":"Mimesh","year":"2004","journal-title":"Contact Dermat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/j.1600-0536.2007.00999.x","article-title":"Occupational allergic contact dermatitis from azithromycin in pharmaceutical workers: A case series","volume":"56","author":"Macan","year":"2007","journal-title":"Contact Dermat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e358","DOI":"10.1111\/j.1365-2230.2009.03313.x","article-title":"Occupational airborne contact dermatitis from azithromycin","volume":"34","author":"Romaguera","year":"2009","journal-title":"Clin. Exp. Derm."},{"key":"ref_19","first-page":"279","article-title":"Anaphylactic death from erythromycin","volume":"89","author":"Bower","year":"1958","journal-title":"Calif. Med."},{"key":"ref_20","first-page":"9","article-title":"Severe urticaria following erythromycin therapy","volume":"3","author":"Prasad","year":"1960","journal-title":"Acta Med. Iran"},{"key":"ref_21","first-page":"18","article-title":"Use of erythromycin ethyl succinate in allergic children","volume":"27","author":"Crawford","year":"1969","journal-title":"Ann. Allergy"},{"key":"ref_22","first-page":"84","article-title":"Erythromycin estolate in general practice. A comparative trial of two dosage forms","volume":"202","author":"Grainger","year":"1969","journal-title":"Practitioner"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1001\/archinte.1978.03630320088033","article-title":"Acute Respiratory Distress Caused by Erythromycin Hypersensitivity","volume":"138","author":"Abramov","year":"1972","journal-title":"Arch. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/00007611-197208000-00004","article-title":"The Schonlein-Henoch syndrome: Glomerulonephritis following erythromycin","volume":"65","author":"Handa","year":"1972","journal-title":"South Med. J"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1159\/000251245","article-title":"Bullous fixed drug eruption presumably due to erythromycin","volume":"152","author":"Naik","year":"1976","journal-title":"Dermatologica"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/j.1600-0536.1976.tb03085.x","article-title":"Immediate-and delayed-type allergy to erythromycin","volume":"2","year":"1976","journal-title":"Contact Dermat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/j.1445-5994.1977.tb03689.x","article-title":"Erythromycin jaundice: Diagnosis by an in vitro challenge test","volume":"7","author":"Cooksley","year":"1977","journal-title":"Aust. N. Z. J. Med."},{"key":"ref_28","first-page":"320","article-title":"Erythromycin estolate hepatotoxicity","volume":"132","author":"Sherman","year":"1978","journal-title":"Am J Dis. Child"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"297","DOI":"10.7326\/0003-4819-89-3-297","article-title":"Legionnaires\u2019 disease: Clinical features of 24 cases","volume":"89","author":"Kirby","year":"1978","journal-title":"Ann. Intern Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"994","DOI":"10.14219\/jada.archive.1978.0427","article-title":"Multiple antibiotic allergies","volume":"97","author":"Harris","year":"1978","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/BF01297126","article-title":"Cholestatic and hepatocellular injury associated with erythromycin esters: Report of nine cases","volume":"24","author":"Zafrani","year":"1979","journal-title":"Dig Dis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S0140-6736(79)90420-3","article-title":"Legionnaires\u2019 disease caused by Legionella pneumophila serogroup 3","volume":"2","author":"Hartigan","year":"1979","journal-title":"Lancet"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2340\/0001555561171173","article-title":"Stevens-Johnson syndrome associated with intrahepatic cholestasis and respiratory disease: A case report","volume":"61","author":"Schonheyder","year":"1981","journal-title":"Acta Derm. Venereol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/BF01393764","article-title":"Hepatotoxicity to both erythromycin estolate and erythromycin ethylsuccinate","volume":"27","author":"Keeffe","year":"1982","journal-title":"Dig. Dis. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/j.1600-0536.1982.tb04270.x","article-title":"Delayed hypersensitivity to erythromycin","volume":"8","author":"Lombardi","year":"1982","journal-title":"Contact Dermat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1136\/bmj.286.6369.938","article-title":"Interstitial nephritis with acute renal failure after erythromycin","volume":"286","author":"Rosenfeld","year":"1983","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_37","first-page":"631","article-title":"Rash due to erythromycin","volume":"17","author":"Furniss","year":"1983","journal-title":"Drug Intell. Clin. Pharm."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/0002-9343(84)91013-1","article-title":"Cholestatic hepatitis from erythromycin ethylsuccinate. Report of two cases","volume":"76","author":"Diehl","year":"1984","journal-title":"Am. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"272","DOI":"10.2340\/0001555564272273","article-title":"Fixed drug eruption to erythromycin","volume":"64","author":"Pigatto","year":"1984","journal-title":"Acta Derm. Venereol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1600-0536.1985.tb02565.x","article-title":"Toxic epidermal necrolysis due to erythromycin","volume":"13","author":"Oxholm","year":"1985","journal-title":"Contact Dermat."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0272-6386(88)80144-6","article-title":"Drug hypersensitivity causing granulomatous interstitial nephritis","volume":"11","author":"Singer","year":"1988","journal-title":"Am. J. Kidney Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1148\/radiology.169.3.3055031","article-title":"Erythromycin-induced hepatitis: Simulator of malignancy","volume":"169","author":"Rigauts","year":"1988","journal-title":"Radiology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1742-1241.1989.tb08808.x","article-title":"Erythromycin rash in glandular fever","volume":"43","author":"Pendleton","year":"1989","journal-title":"Br. J. Clin. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/0140-6736(90)92475-W","article-title":"Toxic epidermal necrolysis due to paediatric erythromycin\/sulfisoxazole combination","volume":"336","author":"Guillonneau","year":"1990","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1398-9995.1991.tb00546.x","article-title":"Fixed eruption due to erythromycin. A case report","volume":"46","year":"1991","journal-title":"Allergy"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2500\/108854191778879124","article-title":"Multiple antibiotic sensitivity in a pediatric population","volume":"12","author":"Kamada","year":"1991","journal-title":"Allergy Proc."},{"key":"ref_47","first-page":"216","article-title":"Adverse cutaneous reactions due to macrolides","volume":"66","author":"Igea","year":"1991","journal-title":"Ann. Allergy"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1111\/j.1365-4362.1991.tb02633.x","article-title":"Fixed drug eruption caused by erythromycin","volume":"30","author":"Mutalik","year":"1991","journal-title":"Int. J. Derm."},{"key":"ref_49","first-page":"1522","article-title":"Erythromycin base-induced rash and liver function disturbances","volume":"26","author":"Shirin","year":"1992","journal-title":"Ann. Pharm."},{"key":"ref_50","first-page":"225","article-title":"Urticaria from erythromycin","volume":"21","year":"1993","journal-title":"Allergol. Immunopathol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1600-0536.1994.tb00729.x","article-title":"Systemic contact dermatitis from erythromycin","volume":"30","author":"Casas","year":"1994","journal-title":"Contact Dermat."},{"key":"ref_52","first-page":"13","article-title":"Stevens-Johnson syndrome associated with erythromycin therapy","volume":"108","author":"Pandha","year":"1995","journal-title":"N. Z. Med. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/S0091-6749(95)70170-2","article-title":"In vitro detection of specific IgE antibodies to erythromycin","volume":"95","author":"Pascual","year":"1995","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1365-4362.1995.tb01593.x","article-title":"Drug-induced acute generalized exanthematous pustulosis with positive patch tests","volume":"34","author":"Moreau","year":"1995","journal-title":"Int. J. Derm."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1093\/ajhp\/52.16.1805","article-title":"Stevens-Johnson syndrome following erythromycin administration","volume":"52","author":"Lestico","year":"1995","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/j.1600-0536.1995.tb02063.x","article-title":"Allergic contact dermatitis from erythromycin","volume":"33","author":"Martins","year":"1995","journal-title":"Contact Dermat."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1111\/j.1365-2222.1996.tb00581.x","article-title":"Evidence of antibodies to erythromycin in serum of a patient following an episode of acute drug-induced hepatitis","volume":"26","author":"Carrasquer","year":"1996","journal-title":"Clin. Exp. Allergy"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/j.1600-0536.1996.tb02248.x","article-title":"Contact allergy to erythromycin","volume":"34","author":"Valsecchi","year":"1996","journal-title":"Contact Dermat."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/S1081-1206(10)63349-2","article-title":"Anaphylaxis to erythromycin","volume":"77","author":"Morales","year":"1996","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1159\/000246167","article-title":"Baboon syndrome","volume":"194","author":"Goossens","year":"1997","journal-title":"Dermatology"},{"key":"ref_61","first-page":"S138","article-title":"Hypersensitivity to erythromycin: Cross Reactivity (A571)","volume":"101","author":"Aragoneses","year":"1998","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_62","first-page":"104","article-title":"Pustulosis by Erythromycin","volume":"53","author":"Quinones","year":"1998","journal-title":"Allergy"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1046\/j.1365-2133.1998.02313.x","article-title":"The use of skin testing in the investigation of cutaneous adverse drug reactions","volume":"139","author":"Barbaud","year":"1998","journal-title":"Br. J. Derm."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1046\/j.1365-4362.1998.00451.x","article-title":"Drugs causing fixed eruptions: A study of 450 cases","volume":"37","author":"Mahboob","year":"1998","journal-title":"Int. J. Derm."},{"key":"ref_65","first-page":"76","article-title":"Cholestasis and liver cell damage due to hypersensitivity to erythromycin stearate\u2013recurrence following therapy with erythromycin succinate","volume":"111","author":"Horn","year":"1999","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_66","first-page":"375","article-title":"Hypersensitivity reaction to erythromycin","volume":"64","author":"Gallardo","year":"1999","journal-title":"Cutis"},{"key":"ref_67","first-page":"1369","article-title":"Stevens-Johnson syndrome secondary to erythromycin","volume":"33","author":"Sullivan","year":"1999","journal-title":"Ann. Pharm."},{"key":"ref_68","first-page":"95","article-title":"Cutaneous adverse drug reactions: Clinical pattern and causative agents\u2013a 6 year series from Chandigarh, India","volume":"47","author":"Sharma","year":"2001","journal-title":"J. Postgrad. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/milmed\/165.8.636","article-title":"Stevens-Johnson syndrome after erythromycin therapy while deployed at sea","volume":"165","author":"Williams","year":"2000","journal-title":"Mil. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1034\/j.1398-9995.2002.13439.x","article-title":"FDE to macrolides","volume":"57","author":"Gomez","year":"2002","journal-title":"Allergy"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"965","DOI":"10.2165\/00002018-200225130-00006","article-title":"Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis in children: A review of 10 years\u2019 experience","volume":"25","author":"Forman","year":"2002","journal-title":"Drug Saf."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijporl.2005.05.012","article-title":"Drug eruptions in children with ENT infections","volume":"70","author":"Rallis","year":"2006","journal-title":"Int. J. Pediatric Otorhinolaryngol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1365-2222.2007.02870.x","article-title":"Drug allergy claims in children: From self-reporting to confirmed diagnosis","volume":"38","author":"Fonseca","year":"2008","journal-title":"Clin. Exp. Allergy"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1365-2125.2008.03192.x","article-title":"Report of oral clarithromycin desensitization","volume":"66","author":"Holmes","year":"2008","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.aller.2010.06.008","article-title":"Suspicion of macrolide allergy after treatment of infectious diseases including Helicobacter pylori: Results of allergological testing","volume":"39","author":"Seitz","year":"2011","journal-title":"Allergol. Immunopathol."},{"key":"ref_76","first-page":"1","article-title":"An illusion of septic shock: Acute generalised exanthematous pustulosis with multiorgan dysfunction","volume":"2017","author":"Jakkidi","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/S0895-4356(98)00041-9","article-title":"Skin reactions to antibacterial agents in general practice","volume":"51","author":"Vlug","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/clind\/15.3.563","article-title":"Clarithromycin-induced thrombocytopenia","volume":"15","author":"Price","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/BF01970967","article-title":"Clarithromycin-induced leukocytoclastic vasculitis","volume":"12","author":"Blanco","year":"1993","journal-title":"Eur J. Clin. Microbiol. Infect. Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1093\/clinids\/19.6.1170-a","article-title":"Clarithromycin-induced thrombocytopenic purpura","volume":"19","author":"Oteo","year":"1994","journal-title":"Clin. Infect. Dis."},{"key":"ref_81","first-page":"300","article-title":"Hypersensitivity reaction to clarithromycin","volume":"30","author":"Vangala","year":"1996","journal-title":"Ann. Pharm."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1398-9995.1998.tb03787.x","article-title":"Hypersensitivity reaction to clarithromycin","volume":"53","author":"Igea","year":"1998","journal-title":"Allergy"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1600-0536.1998.tb05661.x","article-title":"Fixed drug eruption from clarithromycin","volume":"38","author":"Rosina","year":"1998","journal-title":"Contact Dermat."},{"key":"ref_84","first-page":"543","article-title":"Leukocytoclastic vasculitis associated with clarithromycin","volume":"32","author":"Gavura","year":"1998","journal-title":"Ann. Pharm."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1046\/j.1365-4362.1999.00741.x","article-title":"Henoch-Schonlein purpura induced by clarithromycin","volume":"38","author":"Goldberg","year":"1999","journal-title":"Int. J. Derm."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1046\/j.1365-2230.2001.00760.x","article-title":"Fixed drug eruption due to clarithromycin","volume":"26","author":"Hamamoto","year":"2001","journal-title":"Clin. Exp. Derm."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0301-0546(01)79013-1","article-title":"Immediate reaction to clarithromycin","volume":"29","author":"Gangemi","year":"2001","journal-title":"Allergol. Immunopathol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1001\/archinte.162.4.474","article-title":"Fulminant hepatitis and fatal toxic epidermal necrolysis (Lyell disease) coincident with clarithromycin administration in an alcoholic patient receiving disulfiram. therapy","volume":"162","author":"Masia","year":"2002","journal-title":"Arch. Int. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"213","DOI":"10.5414\/CPP41213","article-title":"Henoch-Schonlein purpura associated with clarithromycin. Case report and review of literature","volume":"41","author":"Enriquez","year":"2003","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1136\/bmj.326.7403.1377","article-title":"Clarithromycin and pulmonary infiltration with eosinophilia","volume":"326","author":"Terzano","year":"2003","journal-title":"BMJ"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1468-3083.2004.00772.x","article-title":"Fatal aplastic anaemia in a patient with clarithromycin-induced toxic epidermal necrolysis","volume":"18","author":"Baz","year":"2004","journal-title":"J. Eur. Acad. Derm. Venereol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"231","DOI":"10.2169\/internalmedicine.43.231","article-title":"Clarithromycin-induced eosinophilic pneumonia","volume":"43","author":"Ohnishi","year":"2004","journal-title":"Int. Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.0105-1873.2005.0650h.x","article-title":"Fixed drug eruption on the tongue due to clarithromycin","volume":"53","author":"Alonso","year":"2005","journal-title":"Contact Dermat."},{"key":"ref_94","first-page":"e264","article-title":"Toxic epidermal necrolysis and clarithromycin","volume":"12","author":"Khaldi","year":"2005","journal-title":"Can J. Clin. Pharmcol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1097\/BCR.0b013e318159a3c7","article-title":"Morbidity and mortality of mucocutaneous diseases in the pediatric population at a tertiary care center","volume":"28","author":"Dore","year":"2007","journal-title":"J. Burn Care Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/j.1365-2230.2007.02504.x","article-title":"Clarithromycin suspension-associated toxic epidermal necrolysis in a 2-year-old girl","volume":"32","author":"Clayton","year":"2007","journal-title":"Clin. Exp. Derm."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/j.1399-3038.2007.00702.x","article-title":"Questionnaire-based survey of lifetime-prevalence and character of allergic drug reactions in German children","volume":"19","author":"Lange","year":"2008","journal-title":"Pediatr Allergy Immunol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/j.1398-9995.2009.01990.x","article-title":"Anaphylactic reaction to clarithromycin in a child","volume":"64","author":"Moore","year":"2009","journal-title":"Allergy"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.anai.2010.03.010","article-title":"Sensitivity and specificity of skin tests in the diagnosis of clarithromycin allergy","volume":"104","author":"Mori","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.anai.2010.08.018","article-title":"Successful clarithromycin desensitization in a multiple macrolide-allergic patient","volume":"105","author":"Swamy","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2165\/11593240-000000000-00000","article-title":"Incidence of toxic epidermal necrolysis and Stevens-Johnson Syndrome in an HIV cohort: An observational, retrospective case series study","volume":"13","author":"Mittmann","year":"2012","journal-title":"Am. J. Clin. Derm."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jaip.2013.01.013","article-title":"Successful clarithromycin desensitization in a macrolide-sensitive pediatric patient","volume":"1","author":"Petitto","year":"2013","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/2279-042X.128152","article-title":"Fixed drug eruption due to clarithromycin","volume":"2","author":"Malkarnekar","year":"2013","journal-title":"J. Res. Pharm. Pract."},{"key":"ref_104","first-page":"128","article-title":"Azithromycin is more allergenic than clarithromycin in children with suspected hypersensitivity reaction to macrolides","volume":"25","author":"Barni","year":"2015","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Blair, P.W., Herrin, D., Abaalkhail, N., and Fiser, W. (2015). DRESS syndrome presenting after initiation of mycobacterium avium complex osteomyelitis treatment. BMJ Case Rep., 2015.","DOI":"10.1136\/bcr-2015-210907"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1159\/000443830","article-title":"Proven Non-beta-LactAm. Antibiotic Allergy in Children","volume":"169","author":"Guvenir","year":"2016","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1365-2230.1994.tb01191.x","article-title":"Toxic pustuloderma associated with azithromycin","volume":"19","author":"Trevisi","year":"1994","journal-title":"Clin. Exp. Derm."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1046\/j.1365-2125.1999.00096.x","article-title":"Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions","volume":"48","author":"Naldi","year":"1999","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_109","first-page":"163","article-title":"Azithromycin eruption in infectious mononucleosis: A proposed mechanism of Interaction","volume":"65","author":"Schissel","year":"2000","journal-title":"Cutis"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S0002-9343(00)00724-5","article-title":"Hypersensitivity syndrome associated with azithromycin","volume":"110","author":"Cascaval","year":"2001","journal-title":"Am. J. Med."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1080\/0036554021000026949","article-title":"Azithromycin-induced rash in infectious mononucleosis","volume":"34","author":"Dakdouki","year":"2002","journal-title":"Scand J. Infect. Dis."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1128\/AAC.47.7.2199-2203.2003","article-title":"Tolerability of azithromycin as malaria prophylaxis in adults in northeast papua, indonesia","volume":"47","author":"Taylor","year":"2003","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_113","first-page":"2292","article-title":"Azithromycin-induced leukocytoclastic vasculitis","volume":"30","author":"Odemis","year":"2003","journal-title":"J. Rheumatol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1046\/j.1398-9995.2003.00336.x","article-title":"Stevens-Johnson syndrome associated with azithromycin followed by transient reactivation of herpes simplex virus infection","volume":"59","author":"Aihara","year":"2004","journal-title":"Allergy"},{"key":"ref_115","first-page":"292","article-title":"Cutaneous adverse drug reactions in hospitalized patients in a tertiary care center","volume":"36","author":"Noel","year":"2004","journal-title":"Indian J. Pharmacol."},{"key":"ref_116","first-page":"40","article-title":"Stevens-Johnson syndrome as an unusual adverse effect of azithromycin","volume":"14","author":"Brkljacic","year":"2006","journal-title":"Acta Derm. Croat."},{"key":"ref_117","first-page":"203","article-title":"Drug-induced linear immunoglobulin A bullous dermatosis mimicking Stevens-Johnson syndrome: A case report","volume":"79","author":"Cummings","year":"2007","journal-title":"Cutis"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"225","DOI":"10.7326\/0003-4819-150-3-200902030-00027","article-title":"Hypersensitivity myocarditis associated with azithromycin exposure","volume":"150","author":"Pursnani","year":"2009","journal-title":"Ann. Int. Med."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/j.1600-0536.2010.01869.x","article-title":"Allergic contact dermatitis caused by azithromycin in an eye drop","volume":"64","year":"2011","journal-title":"Contact Dermat."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1111\/j.1525-1470.2011.01558.x","article-title":"Drug reaction with eosinophilia and Systemic symptoms (DRESS) associated with azithromycin in acute Epstein-Barr virus infection","volume":"28","author":"Bauer","year":"2011","journal-title":"Pediatric Derm."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/039463201402700116","article-title":"Azithromycin anaphylaxis in children","volume":"27","author":"Mori","year":"2014","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_122","first-page":"HD01","article-title":"Azithromycin-induced rash in a patient of infectious mononucleosis\u2014A case report with review of literature","volume":"8","author":"Banerjee","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/ddg.12328","article-title":"Non-occupational allergic contact dermatitis caused by azithromycin in an eye solution","volume":"12","author":"Bras","year":"2014","journal-title":"J. Dtsch. Derm. Ges."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1186\/1752-1947-8-332","article-title":"Drug reaction with eosinophilia and Systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: A case report","volume":"8","author":"Sriratanaviriyakul","year":"2014","journal-title":"J. Med. Case Rep."},{"key":"ref_125","first-page":"e247","article-title":"Acute generalized exanthematous pustulosis by azithromycin","volume":"54","author":"Bordignon","year":"2015","journal-title":"Int. J. Derm."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/0253-7613.174565","article-title":"Azithromycin induced bullous fixed drug eruption","volume":"48","author":"Das","year":"2016","journal-title":"Indian J. Pharmacol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"676 e1-3","DOI":"10.1016\/j.ajem.2015.06.039","article-title":"Stevens-Johnson syndrome after treatment with azithromycin: An uncommon culprit","volume":"34","author":"Nappe","year":"2016","journal-title":"Am. J. Emerg. Med."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/cod.12717","article-title":"Acute generalized exanthematous pustulosis (AGEP) induced by azithromycin","volume":"76","author":"Sierra","year":"2017","journal-title":"Contact Dermat."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.alit.2016.10.002","article-title":"An infant case of severe hypereosinophilia and Systemic symptoms with multiple drug hypersensitivity and reactivation of cytomegalovirus and BK virus","volume":"66","author":"Kobayashi","year":"2017","journal-title":"Allergol. Int."},{"key":"ref_130","first-page":"e253","article-title":"Fixed drug eruption probably induced by azithromycin","volume":"58","author":"An","year":"2017","journal-title":"Australas J. Derm."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"e9112","DOI":"10.1097\/MD.0000000000009112","article-title":"Nursing care of a boy seriously infected with Steven-Johnson syndrome after treatment with azithromycin: A case report and literature review","volume":"97","author":"Xu","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1093\/cid\/cit719","article-title":"Hypersensitivity reactions associated with fidaxomicin use","volume":"58","author":"Iarikov","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_133","first-page":"38","article-title":"Multiple antibiotic sensitivity syndrome in children","volume":"7","author":"Park","year":"2000","journal-title":"Can. J. Clin. Pharmacol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.7326\/0003-4819-140-12-200406150-00009","article-title":"Drug provocation tests in patients with a history suggesting an immediate drug hypersensitivity reaction","volume":"140","author":"Messaad","year":"2004","journal-title":"Ann. Int. Med."}],"container-title":["Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2226-4787\/7\/3\/135\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:21:25Z","timestamp":1760188885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2226-4787\/7\/3\/135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,18]]},"references-count":134,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["pharmacy7030135"],"URL":"https:\/\/doi.org\/10.3390\/pharmacy7030135","relation":{},"ISSN":["2226-4787"],"issn-type":[{"value":"2226-4787","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,18]]}}}