Tags

Type your tag names separated by a space and hit enter

Sulfonamide Hypersensitivity: Fact and Fiction.
J Allergy Clin Immunol Pract 2019 Sep - Oct; 7(7):2116-2123JA

Abstract

Sulfonamide antimicrobials are commonly reported as causing drug allergy and have been implicated in a variety of hypersensitivity reactions including immediate IgE-mediated reactions, benign T-cell-mediated rashes, and severe cutaneous adverse reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms. Cross-reactivity is unlikely between sulfonamide antimicrobials and sulfonamide non-antimicrobials. In patients who develop reactions to a sulfonamide non-antimicrobial, there is no evidence to suggest that sulfonamide antimicrobials and other sulfonamide non-antimicrobials would cross-react. Although immediate skin testing can be performed in patients with histories of immediate reactions, they are infrequently positive and wane over time. Delayed skin testing including patch tests to sulfonamides is rarely positive. Drug challenges are a useful tool for patients with both immediate and delayed reactions to sulfonamides. The role of sulfamethoxazole desensitization is controversial as rates of hypersensitivity reactions are similar between desensitization and drug challenge.

Authors+Show Affiliations

Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Tex. Electronic address: dave.khan@utsouthwestern.edu.Division of Clinical Pharmacology and Toxicology, Department of Pharmacy, University of Toronto, Toronto, Ontario, Canada.Department of Dermatology, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31495421

Citation

Khan, David A., et al. "Sulfonamide Hypersensitivity: Fact and Fiction." The Journal of Allergy and Clinical Immunology. in Practice, vol. 7, no. 7, 2019, pp. 2116-2123.
Khan DA, Knowles SR, Shear NH. Sulfonamide Hypersensitivity: Fact and Fiction. J Allergy Clin Immunol Pract. 2019;7(7):2116-2123.
Khan, D. A., Knowles, S. R., & Shear, N. H. (2019). Sulfonamide Hypersensitivity: Fact and Fiction. The Journal of Allergy and Clinical Immunology. in Practice, 7(7), pp. 2116-2123. doi:10.1016/j.jaip.2019.05.034.
Khan DA, Knowles SR, Shear NH. Sulfonamide Hypersensitivity: Fact and Fiction. J Allergy Clin Immunol Pract. 2019;7(7):2116-2123. PubMed PMID: 31495421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sulfonamide Hypersensitivity: Fact and Fiction. AU - Khan,David A, AU - Knowles,Sandra R, AU - Shear,Neil H, PY - 2019/05/14/received PY - 2019/05/26/revised PY - 2019/05/29/accepted PY - 2019/9/10/entrez KW - Allergy KW - Cross-reactivity KW - Drug challenge KW - Hypersensitivity KW - Skin test KW - Sulfa KW - Sulfonamide SP - 2116 EP - 2123 JF - The journal of allergy and clinical immunology. In practice JO - J Allergy Clin Immunol Pract VL - 7 IS - 7 N2 - Sulfonamide antimicrobials are commonly reported as causing drug allergy and have been implicated in a variety of hypersensitivity reactions including immediate IgE-mediated reactions, benign T-cell-mediated rashes, and severe cutaneous adverse reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms. Cross-reactivity is unlikely between sulfonamide antimicrobials and sulfonamide non-antimicrobials. In patients who develop reactions to a sulfonamide non-antimicrobial, there is no evidence to suggest that sulfonamide antimicrobials and other sulfonamide non-antimicrobials would cross-react. Although immediate skin testing can be performed in patients with histories of immediate reactions, they are infrequently positive and wane over time. Delayed skin testing including patch tests to sulfonamides is rarely positive. Drug challenges are a useful tool for patients with both immediate and delayed reactions to sulfonamides. The role of sulfamethoxazole desensitization is controversial as rates of hypersensitivity reactions are similar between desensitization and drug challenge. SN - 2213-2201 UR - https://www.unboundmedicine.com/medline/citation/31495421/Sulfonamide_Hypersensitivity:_Fact_and_Fiction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-2198(19)30491-X DB - PRIME DP - Unbound Medicine ER -