Cross-reactivity in HIV-infected patients switched from trimethoprim-sulfamethoxazole to dapsone

Pharmacotherapy. 1998 Jul-Aug;18(4):831-5.

Abstract

Study objective: To evaluate the cross-reactivity of dapsone after a documented hypersensitivity reaction to trimethoprim-sulfamethoxazole (TMP-SMX) during prophylaxis for Pneumocystis carinii pneumonia.

Design: Retrospective, chart review, cohort study.

Setting: Two university-affiliated teaching hospitals.

Patients: Sixty patients infected with the human immunodeficiency virus.

Measurements and main results: Thirteen patients (21.7%) had cross-reactivity to dapsone after the reaction to TMP-SMX. No significant risk factors for this response were identified. Most reactions were of mild or moderate severity and rated as possibly or probably caused by one of the agents. Of the 13 patients, 4 (30.8%) continued therapy.

Conclusions: Although cross-reactivity can occur, dapsone may be considered in patients with mild hypersensitivity reactions to TMP-SMX.

MeSH terms

  • Adult
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / therapeutic use*
  • CD4 Lymphocyte Count / drug effects
  • Cohort Studies
  • Cross Reactions
  • Dapsone / administration & dosage
  • Dapsone / adverse effects
  • Dapsone / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Hypersensitivity / etiology
  • Exanthema / chemically induced
  • Female
  • Fever / chemically induced
  • Follow-Up Studies
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Humans
  • Male
  • Middle Aged
  • Pruritus / chemically induced
  • Retrospective Studies
  • Time Factors
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
  • Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*
  • Urticaria / chemically induced

Substances

  • Anti-Infective Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Dapsone