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Basophil Activation Test for Allergy Diagnosis07:22

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Related Experiment Video

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Sulfonamide Allergies.

Amber Giles1,2, Jaime Foushee3,4, Evan Lantz5

  • 1Presbyterian College School of Pharmacy, 307 N. Broad St., Clinton, SC 29325, USA. agiles3@its.jnj.com.

Pharmacy (Basel, Switzerland)
|September 14, 2019
PubMed
Summary

Sulfonamide antimicrobial allergies affect 3-8% of people, with HIV patients experiencing them more frequently. Allergy management depends on reaction severity, with desensitization possible for milder cases.

Keywords:
allergyantimicrobialscross-reactionhypersensitivitysulfasulfonamide

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Area of Science:

  • Pharmacology
  • Immunology
  • Infectious Diseases

Background:

  • Sulfonamides are early antimicrobial agents still vital for treating infections.
  • Sulfonamide allergies occur in 3-8% of the general population, manifesting primarily as rash.
  • Patients with human immunodeficiency virus (HIV) have a 10-20 times higher incidence of sulfonamide-related dermatologic reactions.

Purpose of the Study:

  • To detail the incidence, clinical manifestations, and risk factors of sulfonamide allergies.
  • To review the potential for cross-reactivity between sulfonamide antimicrobials and non-antimicrobial sulfonamide drugs.
  • To guide healthcare practitioners in managing patients with sulfonamide allergies.

Main Methods:

  • Literature review on sulfonamide allergy incidence, presentation, and risk factors.
  • Analysis of data concerning cross-reactivity between different sulfonamide classes.
  • Evaluation of management strategies including assessment, rechallenge, and desensitization.

Main Results:

  • Sulfonamide allergies are common, with rash being the most frequent manifestation.
  • HIV-positive individuals exhibit significantly higher rates of sulfonamide-induced skin reactions.
  • Allergic determinant is likely related to N1 and N4 substitutions, not the core sulfonamide structure.
  • Cross-allergenicity between antimicrobial and non-antimicrobial sulfonamides appears low.

Conclusions:

  • Sulfonamide allergies necessitate careful patient assessment, especially in HIV-positive individuals.
  • Management strategies should be tailored to reaction severity, considering rechallenge or desensitization for specific reactions.
  • The risk of cross-allergy between sulfonamide antimicrobials and non-antimicrobial sulfonamides is minimal, allowing for safer therapeutic choices.