Clindamycin and taste disorders

• Published in: British journal of clinical pharmacology Vol. 64; no. 4; pp. 542 - 545
• Main Authors: De Groot, Mark C. H., Van Puijenbroek, Eugène P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2007; Blackwell Science
• Subjects: Adult; adverse drug reaction; Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; clindamycin; Clindamycin - administration & dosage; Clindamycin - adverse effects; Clindamycin - therapeutic use; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Drug Administration Routes; dysgeusia; Female; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Netherlands; Neurology; Odds Ratio; Pharmacology. Drug treatments; pharmacovigilance; Short Reports; taste disorder; Taste Disorders - chemically induced; Netherlands; Drug; Nervous system diseases; Antibiotic; Toxicity; adverse drug reaction; Clindamycin; Pharmacovigilance; Neurological disorder; Antibacterial agent; Taste disorder; dysgeusia
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/j.1365-2125.2007.02908.x

What is already known about this subject. • The antibiotic clindamycin has a bitter taste when it is used orally. What this study adds • A case series on oral as well as i.v. use of clindamycin associated with taste disorders is presented. • After corrections in a case‐by‐case analysis for several possible confounders such as indication, clindamycin is disproportionally associated with taste disorders. • Serum and hence saliva and sputum clindamycin levels seem to be responsible for this reversible adverse drug reaction. Aims Topical use of clindamycin has been associated with taste disorders in the literature, but little is known about the nature of this adverse drug reaction. The aim of this article was to describe reports of clindamycin‐induced taste disorders and to analyse the factors involved. Methods The adverse drug reaction database of the Netherlands Pharmacovigilance Centre was searched for reports concerning taste disorders with antibiotics. Clinical review of the cases and statistical analysis with logistic regression were performed. Characteristics of patients who reported taste disorders were compared for age, gender and formulation in clindamycin vs. other antibiotic users. Results Taste disorders were reported in seven (18%) of the clindamycin cases. In five reports an oral formulation was involved, in one report intravenous (i.v.) administration and in one report both formulations were used. Latency was <1 day after start and in one case taste disorders were present repeatedly at 10 min after every i.v. application. The adjusted reporting odds ratio was 7.0 (95% confidence interval 2.8, 17.3) and supports a possible causal relationship. Conclusions The association of clindamycin and taste disorders is supported by disproportionality analysis and seems to be independent of possible confounders such as age, gender and infections. The case reports suggest a role for clindamycin concentrations excreted in body fluids like saliva.