Management of drug allergy in patients with acquired immunodeficiency syndrome. NLM AIDSLINE Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.

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Management of drug allergy in patients with acquired immunodeficiency syndrome.

J Allergy Clin Immunol. 1987 Mar;79(3):484-8. Unique Identifier : AIDSLINE MED/87138904
Greenberger PA; Patterson R

Abstract: Management of patients with acquired immunodeficiency syndrome (AIDS) is complicated by a high frequency of adverse drug reactions to trimethoprim-sulfamethoxazole and pentamidine. Because of the lack of suitable alternative antiparasitic drugs, some patients who have experienced previous allergic-type reactions to antimicrobial agents may require readministration with incriminated drugs. We report the outcome of seven drug-allergic patients with AIDS evaluated from 1982 to 85. Readministration of pentamidine was carried out without repeated reactions in three patients, and sulfadiazine and sulfamethoxazole-trimethoprim were readministered after very cautious test dosing in two other patients. A generalized maculopapular rash developed after 10 days of sulfadiazine therapy for Toxoplasma chorioretinitis but has been managed with prednisone, 20 to 30 mg/day for 3 months, and sulfadiazine has been continued. The administration of prednisone, 100 to 200 mg daily for treatment of severe cutaneous vasculitis from azulfidine in another patient, did not result in suprainfection. The complexities and potential legal risk of readministration of drugs in the drug-allergic patient with AIDS are emphasized in that coincidental deaths occurred in two patients 48 and 96 hours after readministration of pentamidine.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY Adult Drug Hypersensitivity/COMPLICATIONS/*THERAPY Human Injections, Intravenous Male Middle Age Pentamidine/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Sulfonamides/ADVERSE EFFECTS Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE

KWDacquiredimmunodeficiencysyndrome/KWDcomplications/immunologyadultdrughypersensitivity/complications/KWDtherapyhumaninjections,intravenousmalemiddleagepentamidine/administration&dosage/adverseeffectssulfonamides/adverseeffectssupport,non-uKWDsKWDgov'tsupport,uKWDsKWDgov't,pKWDhKWDsKWDjournalarticle
870630
M8760373

Copyright © 1987 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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