Rapid oral desensitization to trimethoprim-sulfamethoxazole in infants and children.
BACKGROUND
Although trimethoprim-sulfamethoxazole is the preferred chemoprophylaxis against Pneumocystis carinii pneumonia, there are frequent IgE-mediated reactions among children infected with the human immunodeficiency virus (HIV). Oral desensitization allows more patients to receive chemoprophylaxis, but it has been studied in only a limited number of children.


METHODS
We desensitized five children infected with the HIV using a rapid, 4-h oral protocol.


RESULTS
Three children (including two infants) successfully completed desensitization and started maintenance therapy, but the other two experienced reactions that precluded further administration of trimethoprim-sulfamethoxazole.


CONCLUSIONS
We conclude that a rapid, oral trimethoprim-sulfamethoxazole desensitization protocol is safe and, in some instances, effective among HIV-infected children and infants with a history of non-life-threatening, IgE-mediated reactions to trimethoprim-sulfamethoxazole.
Palusci
V J
VJ
Department of Pediatrics, New York University School of Medicine, Bellevue Hospital Center, NY, USA.
Kaul
A
A
Lawrence
R M
RM
Haines
K A
KA
Kwittken
P L
PL
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000284:Administration, Oral; D016516:CD4-CD8 Ratio; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D018655:Lymphocyte Count; D008297:Male; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000276:immunology*
D015662:Trimethoprim, Sulfamethoxazole Drug Combination