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Review

Sulfonamide Allergies

1
Presbyterian College School of Pharmacy, 307 N. Broad St., Clinton, SC 29325, USA
2
Janssen Scientific Affairs, LLC., 1125 Trenton Harbourton Rd., Titusville, NJ 08560, USA
3
Edward Via College of Osteopathic Medicine Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
4
Spartanburg Regional Healthcare System, 101 E. Wood St., Spartanburg, SC 29303, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2019, 7(3), 132; https://doi.org/10.3390/pharmacy7030132
Received: 3 July 2019 / Revised: 2 August 2019 / Accepted: 5 August 2019 / Published: 11 September 2019
(This article belongs to the Special Issue Antibiotic 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 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 N1 and N4 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. View Full-Text
Keywords: antimicrobials; allergy; hypersensitivity; cross-reaction; sulfonamide; sulfa antimicrobials; allergy; hypersensitivity; cross-reaction; sulfonamide; sulfa
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MDPI and ACS Style

Giles, A.; Foushee, J.; Lantz, E.; Gumina, G. Sulfonamide Allergies. Pharmacy 2019, 7, 132. https://doi.org/10.3390/pharmacy7030132

AMA Style

Giles A, Foushee J, Lantz E, Gumina G. Sulfonamide Allergies. Pharmacy. 2019; 7(3):132. https://doi.org/10.3390/pharmacy7030132

Chicago/Turabian Style

Giles, Amber, Jaime Foushee, Evan Lantz, and Giuseppe Gumina. 2019. "Sulfonamide Allergies" Pharmacy 7, no. 3: 132. https://doi.org/10.3390/pharmacy7030132

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