2018
DOI: 10.1007/s11882-018-0791-9
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Sulfonamide Drug Allergy

Abstract: There do not appear to be consistent genetic markers to reliably predict features of or the presence hypersensitivity reactions. Recent evidence continues to alleviate early concerns cross-reactivity between sulfonamide antibiotics and non-antibiotics. Sulfonamide drug allergy is frequently encountered by the practicing clinician. For sulfonamide antibiotics, delayed rash is the most common clinical manifestation. There is no current evidence to support avoidance of all non-antibiotic sulfonamides in those wit… Show more

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Cited by 32 publications
(21 citation statements)
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“…The increased acidity also greatly improves the water solubility of sulfonamide antimicrobials, which is important since the undissociated forms of these molecules and their acetate metabolites tend to have low solubility, which can be responsible for crystalluria. These additional groups are believed to be the primary determinant of allergy, rather than the base NH 2 -SO 2 moiety contained in all sulfonamides (Figure 3) [1,3,23,24,25]. The majority of nonantimicrobial sulfonamides lack these additional groups, with the exception of the antiretroviral agents, amprenavir and fosamprenavir, which contain an N 4 -arylamine group (but not an N 1 -heterocyclic ring) [2].…”
Section: Sulfonamide Allergymentioning
confidence: 99%
“…The increased acidity also greatly improves the water solubility of sulfonamide antimicrobials, which is important since the undissociated forms of these molecules and their acetate metabolites tend to have low solubility, which can be responsible for crystalluria. These additional groups are believed to be the primary determinant of allergy, rather than the base NH 2 -SO 2 moiety contained in all sulfonamides (Figure 3) [1,3,23,24,25]. The majority of nonantimicrobial sulfonamides lack these additional groups, with the exception of the antiretroviral agents, amprenavir and fosamprenavir, which contain an N 4 -arylamine group (but not an N 1 -heterocyclic ring) [2].…”
Section: Sulfonamide Allergymentioning
confidence: 99%
“…Desensitization has also been used successfully in a number of HIV-associated IM-ADRs, often even in preference to DPT, especially when the offending drug is easily identified on history. Cotrimoxazole reactions are perhaps the best known, with several available desensitization protocols [78], and a Cochrane meta-analysis suggesting that desensitization was more successful than rechallenge in preventing cotrimoxazole discontinuation, and in reducing overall drug-related adverse effects [79]. Desensitization has also been successfully attempted in several drugs shown in Table 1 as referenced in previous reviews [20,21].…”
Section: Supported Treat Through Slow Reintroduction or Desensitizationmentioning
confidence: 99%
“…The most common manifestation of hypersensitivity reaction to sulfonamide antibiotics is a non‐blistering rash, at times accompanied by fever. The pathophysiology of sulfonamide hypersensitivity is heterogeneous and likely multifactorial in nature . Immediate‐type IgE‐mediated reactions to sulfonamide antibiotics are unusual, and it is delayed‐type T cell–mediated mechanisms that are responsible for the majority of reactions.…”
Section: Introductionmentioning
confidence: 99%