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Sulfonamide Allergies

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 a...

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Autores principales: Giles, Amber, Foushee, Jaime, Lantz, Evan, Gumina, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789825/
https://www.ncbi.nlm.nih.gov/pubmed/31514363
http://dx.doi.org/10.3390/pharmacy7030132
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author Giles, Amber
Foushee, Jaime
Lantz, Evan
Gumina, Giuseppe
author_facet Giles, Amber
Foushee, Jaime
Lantz, Evan
Gumina, Giuseppe
author_sort Giles, Amber
collection PubMed
description 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 N(1) and N(4) 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.
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spelling pubmed-67898252019-10-16 Sulfonamide Allergies Giles, Amber Foushee, Jaime Lantz, Evan Gumina, Giuseppe Pharmacy (Basel) Review 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 N(1) and N(4) 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. MDPI 2019-09-11 /pmc/articles/PMC6789825/ /pubmed/31514363 http://dx.doi.org/10.3390/pharmacy7030132 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Giles, Amber
Foushee, Jaime
Lantz, Evan
Gumina, Giuseppe
Sulfonamide Allergies
title Sulfonamide Allergies
title_full Sulfonamide Allergies
title_fullStr Sulfonamide Allergies
title_full_unstemmed Sulfonamide Allergies
title_short Sulfonamide Allergies
title_sort sulfonamide allergies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789825/
https://www.ncbi.nlm.nih.gov/pubmed/31514363
http://dx.doi.org/10.3390/pharmacy7030132
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