中国药物警戒 ›› 2026, Vol. 23 ›› Issue (6): 686-689.
DOI: 10.19803/j.1672-8629.20250427

• 安全与合理用药 • 上一篇    下一篇

围产期盐酸克林霉素注射液致急性泛发性发疹性脓疱病2例分析

文冉苗, 陈悦, 杨彩华*   

  1. 南方医科大学南方医院临床药学中心,广东 广州 510515
  • 收稿日期:2025-06-30 出版日期:2026-06-15 发布日期:2026-06-18
  • 通讯作者: *杨彩华,女,硕士,主管药师,妊娠哺乳期安全用药。E-mail: xiaoyang856@163.com
  • 作者简介:文冉苗,女,在读本科,药物基因组学。
  • 基金资助:
    广东省自然科学基金资助项目（2023A1515110921）; 南方医科大学大学生创新创业研究项目（S202412121123）

Two Cases of Acute Generalized Exanthematous Pustulosis Caused by Clindamycin Hydrochloride Injection during the Perinatal Period

WEN Ranmiao, CHEN Yue, YANG Caihua*   

  1. Clinical Pharmacy Center, Nanfang Hospital, Southern Medical University, Guangzhou Guangdong 510515, China
  • Received:2025-06-30 Online:2026-06-15 Published:2026-06-18

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摘要： 目的 探讨围产期使用克林霉素致急性泛发性发疹性脓疱病（AGEP）的临床关联性及其潜在风险因素。方法 分析2例孕妇使用克林霉素后发生AGEP的病例，结合国内外相关文献，运用不良反应评价方法分析关联性、临床特征、致敏机制与围产期用药风险。结果 2例孕妇分别有青霉素、林可霉素过敏史，常规使用克林霉素后出现AGEP典型症状，经关联性分析，2例患者发生AGEP与静脉滴注克林霉素关联性均为很可能。停用克林霉素并予抗过敏治疗后症状缓解。结论 分析表明，其发病与T细胞介导的免疫应答、HLA-B*51:01及IL36RN基因多态性、围产期免疫改变等因素相关。围产期使用克林霉素，尤其对于有特定药物过敏史的个体，存在致AGEP的潜在风险。临床建议用药前充分评估风险、加强用药监测，以保障母婴安全。

关键词: 克林霉素, 围产期用药, 妊娠期用药, 急性泛发性发疹性脓疱病, 过敏反应, 基因多态性, 药品不良反应

Abstract: Objective To investigate the clinical correlations between the use of clindamycin during the perinatal period and acute generalized exanthematous pustulosis (AGEP). Methods Two cases of pregnant women who developed AGEP after using clindamycin hydrochloride injection were reviewed. Based on related literature, methods for evaluation of adverse drug reactions were adopted to analyze the correlations between clindamycin and AGEP as well as the clinical characteristics, sensitization mechanisms and risks posed by perinatal medication. Results The two pregnant women, who had a history of penicillin allergy and lincomycin allergy respectively, developed typical symptoms of AGEP after using clindamycin as usual. Correlation analysis found that AGEP was likely associated with intravenous clindamycin infusion in the two women. After discontinuation of clindamycin and anti-allergic treatment, the symptoms were relieved. Conclusion The adverse drug reactions are related to T-cell-mediated immune responses, HLA-B*51:01 and IL36RN gene polymorphisms, and perinatal immune changes. Clindamycin used during the perinatal period, especially in individuals with specific drug allergies, carries a potential risk of inducing AGEP. It is recommended that the risks be assessed before medication and monitoring be enhanced to ensure the safety of both the mother and the fetus.

Key words: Clindamycin, Perinatal Medication, Medication during Pregnancy, Acute Generalized Exanthematous Pustulosis (AGEP), Allergic Reaction, Genetic Polymorphism, Adverse Drug Reaction

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