[Sulfonamide allergy and cross-reactivity].

Area of Science:

• Clinical immunology
• Pharmacology
• Dermatology

Context:

• Sulfonamide antibiotics are frequent triggers of drug hypersensitivity reactions.
• Mechanisms of sulfonamide allergy, including IgE-mediated and cell-mediated responses, require further elucidation.
• Concerns regarding cross-reactivity with non-antibiotic sulfonamides complicate treatment decisions.

Purpose:

• To review the history of sulfonamide allergy.
• To describe the clinical manifestations of sulfonamide hypersensitivity.
• To outline diagnostic approaches and treatment strategies for sulfonamide allergy.

Summary:

• This review details the history, clinical presentations, diagnostic methods, and therapeutic interventions for sulfonamide antibiotic allergy.
• It addresses the spectrum of hypersensitivity reactions, from immediate IgE-mediated to delayed cell-mediated responses.
• The review also clarifies misconceptions about cross-reactivity between sulfonamide antibiotics and other sulfonamide-containing drugs.

Impact:

• Improved understanding of sulfonamide allergy mechanisms and clinical features.
• Guidance for accurate diagnosis and appropriate management of patients with sulfonamide hypersensitivity.
• Reduction of unnecessary drug avoidance due to unfounded cross-reactivity concerns, optimizing patient pharmacotherapy.