• Shenghui Zhou, Shouhui Wang, Yajun Wang, and Fenglin Xi.
• Department of Pharmacy, Baiyin Central Hospital, Baiyin, Gansu, China.
• Medicine (Baltimore). 2024 Nov 22; 103 (47): e40657e40657.

RationaleIt is imperative to be cautious about the potential systemic allergic reaction caused by the combined use of Qing Kailing Injection (QKI) and clindamycin as it may be life-threatening.Patient ConcernsA 48-year-old female with a history of hypertension was admitted to a private hospital with a fever and cough. She was diagnosed with lung infection and received QKI infusion, followed by clindamycin infusion. During clindamycin infusion, the patient experienced convulsions followed by nausea and vomiting (gastric contents). Upon arrival at the emergency room, she lost consciousness, became agitated and sweaty, and had incontinence. Respiratory rate was measured at 32 breaths per minute, pulse rate was 180 beats per minute, temperature was 42°C, and blood pressure was unmeasurable.DiagnosisDrug hypersensitivity reactions.InterventionsThe patient immediately discontinued clindamycin, administered dexamethasone 10 mg intravenously, and was subsequently referred to our hospital for further treatment. Emergency physicians immediately provided oxygen inhalation via a face mask, administered midazolam for sedation and ibuprofen combined with physical measures for cooling, carried out fluid replacement, administered furosemide for diuresis, and avoided using allergenic drugs.OutcomesThe patient regained consciousness, without experiencing further convulsions, nausea, vomiting, fever, or abnormal urination, and their vital signs stabilized.LessonsCaution should be exercised in the concurrent use of traditional Chinese medicine injections and antibacterial drugs in clinical treatment because of the potential for allergic reactions to both medications. If combination therapy is deemed necessary, adequate flushing of the infusion pipe with saline or replacement with a new infusion device is recommended, while closely monitoring the patient for any signs of allergic reactions.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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