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Sulfonamide Allergies.
Pharmacy (Basel) 2019; 7(3)P

Abstract

As one of the earliest developed antimicrobial classes, sulfonamides remain important therapeutic options for the empiric and definitive treatment of various infectious diseases. In the general population, approximately 3-8% of patients are reported to experience a sulfonamide allergy. Sulfonamide allergies can result in various physical manifestations; however, rash is reported as the most frequently observed. In patients with human immunodeficiency virus (HIV), dermatologic reactions to sulfonamide antimicrobial agents occur 10 to 20 times more frequently compared to immunocompetent patients. This article describes the incidence, manifestations, and risk factors associated with sulfonamide allergies. The potential for cross-reactivity of allergies to sulfonamide antimicrobials with nonantimicrobial sulfonamide medications is also reviewed. Data suggest that substitutions at the N1 and N4 positions are the primary determinants of drug allergy instead of the common sulfonamide moiety. For patients with an indication for a sulfonamide antimicrobial with a listed allergy, it is important for healthcare practitioners to adequately assess the allergic reaction to determine appropriate management. Rechallenge and desensitization strategies may be appropriate for patients with delayed maculopapular eruptions, while alternative treatment options may be prudent for more severe reactions. Available data suggests a low risk of cross-allergenicity between sulfonamide antimicrobial and nonantimicrobial agents.

Authors+Show Affiliations

Presbyterian College School of Pharmacy, 307 N. Broad St., Clinton, SC 29325, USA. agiles3@its.jnj.com. Janssen Scientific Affairs, LLC., 1125 Trenton Harbourton Rd., Titusville, NJ 08560, USA. agiles3@its.jnj.com.Presbyterian College School of Pharmacy, 307 N. Broad St., Clinton, SC 29325, USA. jaimeafoushee@gmail.com. Edward Via College of Osteopathic Medicine Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA. jaimeafoushee@gmail.com.Spartanburg Regional Healthcare System, 101 E. Wood St., Spartanburg, SC 29303, USA. elantz@srhs.com.Presbyterian College School of Pharmacy, 307 N. Broad St., Clinton, SC 29325, USA. ggumina@presby.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31514363

Citation

Giles, Amber, et al. "Sulfonamide Allergies." Pharmacy (Basel, Switzerland), vol. 7, no. 3, 2019.
Giles A, Foushee J, Lantz E, et al. Sulfonamide Allergies. Pharmacy (Basel). 2019;7(3).
Giles, A., Foushee, J., Lantz, E., & Gumina, G. (2019). Sulfonamide Allergies. Pharmacy (Basel, Switzerland), 7(3), doi:10.3390/pharmacy7030132.
Giles A, et al. Sulfonamide Allergies. Pharmacy (Basel). 2019 Sep 11;7(3) PubMed PMID: 31514363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sulfonamide Allergies. AU - Giles,Amber, AU - Foushee,Jaime, AU - Lantz,Evan, AU - Gumina,Giuseppe, Y1 - 2019/09/11/ PY - 2019/07/03/received PY - 2019/08/02/revised PY - 2019/08/05/accepted PY - 2019/9/14/entrez KW - allergy KW - antimicrobials KW - cross-reaction KW - hypersensitivity KW - sulfa KW - sulfonamide JF - Pharmacy (Basel, Switzerland) JO - Pharmacy (Basel) VL - 7 IS - 3 N2 - As one of the earliest developed antimicrobial classes, sulfonamides remain important therapeutic options for the empiric and definitive treatment of various infectious diseases. In the general population, approximately 3-8% of patients are reported to experience a sulfonamide allergy. Sulfonamide allergies can result in various physical manifestations; however, rash is reported as the most frequently observed. In patients with human immunodeficiency virus (HIV), dermatologic reactions to sulfonamide antimicrobial agents occur 10 to 20 times more frequently compared to immunocompetent patients. This article describes the incidence, manifestations, and risk factors associated with sulfonamide allergies. The potential for cross-reactivity of allergies to sulfonamide antimicrobials with nonantimicrobial sulfonamide medications is also reviewed. Data suggest that substitutions at the N1 and N4 positions are the primary determinants of drug allergy instead of the common sulfonamide moiety. For patients with an indication for a sulfonamide antimicrobial with a listed allergy, it is important for healthcare practitioners to adequately assess the allergic reaction to determine appropriate management. Rechallenge and desensitization strategies may be appropriate for patients with delayed maculopapular eruptions, while alternative treatment options may be prudent for more severe reactions. Available data suggests a low risk of cross-allergenicity between sulfonamide antimicrobial and nonantimicrobial agents. SN - 2226-4787 UR - https://www.unboundmedicine.com/medline/citation/31514363/Sulfonamide_Allergies DB - PRIME DP - Unbound Medicine ER -
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