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Can you take Biaxin if you’re allergic to penicillin?

Medically reviewed by Sally Chao, MD. Last updated on Nov 9, 2021.

Official answer


Yes, you can safely take Biaxin (clarithromycin) if you are allergic to penicillin. Clarithromycin and penicillin are both antibiotics, but they are in different antibiotic classes.

  • Penicillin is in the penicillin family, along with amoxicillin. Not everyone with a penicillin allergy will also react poorly to amoxicillin, but some will.
  • Clarithromycin is in the macrolides class of antibiotics, along with the drugs azithromycin and erythromycin.
  • Macrolides and penicillins have different methods of killing bacteria and thus do not trigger the same reactions in people with an allergy to one or the other.

Clarithromycin (such as Biaxin) or other drugs in the same antibiotic class (such as erythromycin) are often the standard treatment for infections typically treated with penicillins in patients with a penicillin allergy. For example, patients with a penicillin allergy may be prescribed clarithromycin instead of amoxicillin to prevent oral bacteria from spreading to the heart and causing a heart infection before a dental procedure.

Clarithromycin may also be prescribed to patients who cannot take penicillin for ear infections, tonsillitis and some skin infections.

  1. National Health Service (NHS). Guidance on Antibiotic Choice for Patients with Penicillin Hypersensitivity. August 2010. Available at: [Accessed September 29, 2021].
  2. Centers for Disease Control and Prevention (CDC). Antibiotic Resistance & Patient Safety Portal: Outpatient Antibiotic Prescription Data. Available at: [Accessed September 29, 2021].
  3. American College of Allergy, Asthma, & Immunology (ACAAI). Drug Allergies. February 28, 2018. Available at: [Accessed September 29, 2021].
  4. National Health Service (NHS). Clarithromycin. December 6, 2018. Available at: [Accessed September 29, 2021].
  5. American Academy of Pediatric Dentistry (AAPD). Antibiotic prophylaxis for dental patients at risk for infection. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2020:447-52. Available at: [Accessed September 28, 2021].
  6. Shaeer KM, Chahine EB, Varghese Gupta S. Macrolide Allergic Reactions. Pharmacy (Basel). 2019;7(3):135. 2019 Sep 18.

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