Efficacy of Percutaneous and Intradermal Skin Tests, and Patch Test to Predict Hypersensitivity to Trimetropin-Sulfametoxazol (TMP-SMX) in Hiv-infected Patients

Guevara, Palmira; Delgado, Diogo; Vivas, G.R. Hernandez; Parada, V. Quintero

doi:10.1016/j.jaci.2005.12.901

Journal of Allergy and Clinical Immunology

2006

DOI: 10.1016/j.jaci.2005.12.901

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Efficacy of Percutaneous and Intradermal Skin Tests, and Patch Test to Predict Hypersensitivity to Trimetropin-Sulfametoxazol (TMP-SMX) in Hiv-infected Patients

Palmira Guevara

Diogo Delgado

G.R. Hernandez Vivas

et al.

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Patch testing in non‐immediate hypersensitivity to cotrimoxazole: Is it useful?

Soares,

Teixeira,

Figueiredo

et al. 2024

Contact Dermatitis

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BackgroundExisting literature has questioned the sensitivity of patch testing (PT) with cotrimoxazole (CTX) in the study of drug hypersensitivity.ObjectivesAssess the sensitivity of PT with CTX in non‐immediate cutaneous adverse drug reactions (CADR).Patients/Materials/MethodsRetrospective analysis (2000–2022) of PT with an antibiotic series including CTX 10% pet (Chemotechnique Diagnostics©) performed according to ESCD guidelines in patients with suspected non‐immediate CADR reactions to CTX. Some patients were additionally tested with in‐house preparations of CTX from Bactrim DS® tablets at 10% in pet or water and trimethoprim 10% pet (Laboratórios Edol©).ResultsSixty‐four patients (48F/16M; mean age 47 ± 18) were included, mostly with maculopapular exanthema (51, 80%). Notably, CTX was sole suspect in 24 patients. There was no positive reaction to CTX at 10% from Chemotechnique or Bactrim DS® tablets prepared at 10% pet for patch testing. One patient reacted exclusively to trimethoprim with 1+ reaction. Two patients had a faint reaction (1+) only with the powder of Bactrim DS® tablets in water at D2, but as the reactions faded completely in 24 or 48 h, they were interpreted as irritant non‐specific reactions.ConclusionThese findings suggest that patch testing may lack sufficient sensitivity to diagnose CTX‐induced non‐immediate CADR. Therefore, clinicians should be cautious interpreting CTX patch test results.

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Patch testing in non‐immediate hypersensitivity to cotrimoxazole: Is it useful?

Soares,

Teixeira,

Figueiredo

et al. 2024

Contact Dermatitis

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Survey of Drug Allergy Testing, Challenge, and Desensitization Practice

HB¹

2012

J Clin Toxicol

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Background: The lack of standardized skin test products to determine a patient's (hyper-) sensitivity to medications has required physicians to empirically develop their own testing procedures. These approaches include puncture and intradermal skin tests, patch tests and medication challenges. Desensitization protocols are also frequently used when the necessity of a particular medication is urgent. Objective: This study surveyed drug hypersensitivity testing and desensitization practices reported in 3 allergy journals, over a 5-year period 2004-2008. Methods: This survey collected reports of skin tests, challenges, and desensitization to medications, vaccines, and diagnostic agents in 3 leading allergy journals. Studies were included if they reported sufficient detail that the reader could reasonably be expected to reproduce the technique reported. We did not include reports of in vitro testing because the ability of the individual practitioner to perform these tests may be limited. Results: Data for 191 drugs were sufficiently detailed to include. Testing with antimicrobial agents was reported most frequently; and several newer classes of medications such as monoclonal antibodies and interferons are also included. Skin testing to detect medication allergy was the most commonly reported technique; however there were numerous drug challenge and drug desensitization schedules used in practice. Conclusion: Beyond testing for medications such as antibiotics, corticosteroids and local anesthetics skin testing, challenge, and desensitization schedules have been described for numerous other medication classes. The variety of these schedules is likely driven both by the needs of clinical practice and the lack of standardized skin test preparations.

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Efficacy of Percutaneous and Intradermal Skin Tests, and Patch Test to Predict Hypersensitivity to Trimetropin-Sulfametoxazol (TMP-SMX) in Hiv-infected Patients

Cited by 2 publications

References 0 publications

Patch testing in non‐immediate hypersensitivity to cotrimoxazole: Is it useful?

Patch testing in non‐immediate hypersensitivity to cotrimoxazole: Is it useful?

Survey of Drug Allergy Testing, Challenge, and Desensitization Practice

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