Does Prior Evidence of Macrolide Allergy Portend Subsequent Fidaxomicin Allergy?

A global database study indicated that a macrolide allergy within the prior year, although rare itself, conferred excess risk for allergy to fidaxomicin.

Although macrolide allergies are uncommon, the similar chemical structures between macrolides and fidaxomicin underlie the warning on the fidaxomicin package insert about cross-allergy in patients with macrolide allergies. However, data are sparse regarding this theoretical concern, and its study is difficult because of the rarity of occurrence.

Chiu and colleagues queried a multinational database that included 129 million patients and found substantial incidence of allergies to azithromycin, clarithromycin, erythromycin, and fidaxomicin. Compared with patients without macrolide allergies, the odds of allergic reactions to fidaxomicin were up to eightfold higher for those with allergies to azithromycin, clarithromycin, or erythromycin. Of th…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases