Co-existence of multiple drug allergies and pregnancy often results in vexing dilemmas for physicians. A 21-year-old pregnant woman presented with asymptomatic cervicitis with dual infection with Chlamydia trachomatis and Neisseria gonorrhoeae during her third trimester. She reported a history of generalised rash with mucous membrane involvement following use of both macrolides and penicillins. Her gonococcal infection was successfully treated with a single dose of intramuscular gentamicin and chlamydial infection with oral clindamycin and rifampicin.
BlumenthalKGLiYAckerWW, et al.Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression. Allergy2018; 73(10): 2012–2023.
2.
FiferHSaundersJSoniS, et al.National guideline for the management of infection with Neisseria gonorrhoeae. Int J STD AIDS2018; 31(1): 4–15.
3.
FarhatSEThibaultMDevlinR. Efficacy of a swab transport system in maintaining viability of neisseria gonorrhoeae and Streptococcus pneumoniae. J Clin Microbiol2001; 39(8): 2958–2960.
4.
NwokoloNCDragovicBPatelS, et al.2015 UK national guideline for the management of infection with chlamydia trachomatis. Int J STD AIDS2015; 27(4): 251–267.
5.
RobaeiDWatsonS. Corneal blindness: a global problem. Clin Exp Ophthalmol2014; 42(3): 213–214.
6.
CampagnaJDBondMCSchabelmanE, et al.The use of cephalosporins in penicillin-allergic patients: a literature review. J Emerg Med2012; 42(5): 612–620.
7.
DicksonSDSalazarKC. Diagnosis and management of immediate hypersensitivity reactions to cephalosporins. Clinic Rev Allerg Immunol2013; 45: 131–142.
8.
DePestelDDBenningerMSDanzigerL, et al.Cephalosporin use in treatment of patients with penicillin allergies. J Am Pharm Assoc2008; 48: 530–540.
9.
LieberASCarrollAEChonmaitreeT, et al.The diagnosis and management of acute otitis media. Pediatrics2013; 131: e964–e999.
10.
Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol-Head Neck Surg (Sinus Allergy Health Partnership)2004; 130(1): 1–45
11.
RossJDCBrittainCColeM, et al.Gentamicin compared with ceftriaxone for the treatment of gonorrhoea (G-ToG): a randomised non-inferiority trial. The Lancet2019; 393: 2511–2520.
12.
KristyMSEliasBCSheebaVG, et al.Pharmacy(Basel)2019; 7(3): 135.
13.
FriedmanJMPolifikaJC. Teratogenic effects of drugs, A resource for clinicians(TERIS). Baltimore, MD: The John Hopkins University Press, 2000, pp. 149–195.
14.
AlgerLSLovchikJC. Comparative efficacy of clindamycin versus erythromycin in eradication of antenatal chlamydia trachomatis. Am J Obstet Gynecol1991; 165: 375–381.
15.
CoufalikEDTaylor-RobinsonDCsonkaGW. Treatment of nongonococcal urethritis with rifampicin as a means of defining the role of ureaplasma urealyticum. Br J Venereal Dis1979; 55: 36–43.