Mayo Clinic, Division of Allergic Diseases, 200 First Street SW, Rochester, MN, 55905, USA.
Curr Allergy Asthma Rep. 2018 Jun 6;18(7):38. doi: 10.1007/s11882-018-0791-9.
We sought to review past and current literature on sulfonamide drug allergy and distill it in a practical manner to assist the clinician, specifically focusing on cross-reactivity and desensitization.
There do not appear to be consistent genetic markers to reliably predict features of or the presence hypersensitivity reactions. Recent evidence continues to alleviate early concerns cross-reactivity between sulfonamide antibiotics and non-antibiotics. Sulfonamide drug allergy is frequently encountered by the practicing clinician. For sulfonamide antibiotics, delayed rash is the most common clinical manifestation. There is no current evidence to support avoidance of all non-antibiotic sulfonamides in those with a reported allergy to sulfonamide antibiotics, although certain scenarios require caution. Available evidence supports the cautious reintroduction of sulfonamide antibiotics via desensitization, which is usually well tolerated and should be considered in those with strong indications for trimethoprim-sulfamethoxazole and a reported sulfonamide allergy.
我们旨在回顾磺胺类药物过敏的既往和现有文献，并以实用的方式对其进行总结，以帮助临床医生，特别是侧重于交叉反应和脱敏。
目前似乎没有一致的遗传标志物来可靠地预测过敏反应的特征或存在。最近的证据继续减轻了早期对磺胺类抗生素和非抗生素之间交叉反应的担忧。磺胺类药物过敏经常被临床医生遇到。对于磺胺类抗生素，延迟性皮疹是最常见的临床表现。目前没有证据支持在报告对磺胺类抗生素过敏的患者中避免所有非抗生素磺胺类药物，尽管某些情况下需要谨慎。现有证据支持通过脱敏谨慎重新引入磺胺类抗生素，这通常耐受性良好，对于有强烈使用甲氧苄啶-磺胺甲恶唑和报告磺胺类药物过敏的指征的患者应考虑使用。
