Macrolide antibiotics--does problem with one automatically rule out others?

Having had pleurisy twice, I know how painful it is! I was uncertain, however, about its being caused by medicines because both times mine developed from a bad case of bronchitis. Here is what I found, with the part I doubted marked with *****:

What causes pleurisy?

Pleurisy can be caused by any of the following conditions:

* Infections: bacterial (including those that cause tuberculosis), fungi, parasites, or viruses

* Inhaled chemicals or toxic substances: exposure to some cleaning agents like ammonia

* Collagen vascular diseases: lupus, rheumatoid arthritis

* Cancers: for example, the spread of lung cancer or breast cancer to the pleura

* Tumors of the pleura: mesothelioma or sarcoma

* Congestion: heart failure

* Pulmonary embolism: blood clot inside the blood vessels to the lungs. These clots sometimes severely reduce blood and oxygen to portions of the lung and can result in death to that portion of lung tissue (termed lung infarction). This, too, can cause pleurisy.

* Obstruction of lymph channels: as a result of centrally located lung tumors

* Trauma: rib fractures or irritation from chest tubes used to drain air or fluid from the pleural cavity in the chest

***** Certain drugs: drugs that can cause lupus-like syndromes (such as hydralazine [Apresoline], Procan [Pronestyl, Procan-SR, Procanbid - these brands no longer are available in the U.S.], phenytoin [Dilantin], and others)

* Abdominal processes: such as pancreatitis, cirrhosis of the liver, gallbladder disease, and damage to the spleen.

* Pneumothorax: air in the pleural space, occurring spontaneously or from trauma.

It sounds like you need to talk with your pharmacist. I very often find myself correcting misconceptions about antibiotic allergies from my physician/NP/PA colleagues -- your pharmacist is well-positioned to get to the bottom of the issues and figure out what can/should be used for you.