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