Probenecid hypersensitivity in AIDS: a case report.
BACKGROUND
Cidofovir plus probenecid is a new therapeutic alternative for refractory cytomegalovirus and acyclovir-resistant herpes infections in AIDS patients. Probenecid is used in conjunction with the antiherpetic medication (cidofovir) in order to reduce the incidence of nephrotoxicity by cidofovir.


OBJECTIVE
To present therapeutic alternatives for successful administration of probenecid to AIDS patients who develop a hypersensitivity reaction to the medication.


RESULTS
We describe a patient with AIDS who was being treated with the cidofovir/probenecid combination for a peri-anal acyclovir-resistant herpetic infection. The patient subsequently developed a cutaneous hypersensitivity reaction to probenecid alone. A pretreatment regimen consisting of prednisone, H1 and H2 blockers was administered before the dosing of probenecid in order for the patient to continue with the antiviral therapy.


CONCLUSIONS
Cutaneous hypersensitivity reactions to probenecid may be seen more frequently with the increasing use of cidofovir in AIDS patients. Our pre-treatment protocol is one therapeutic alternative to be considered in order to continue with probenecid.
Myers
K W
KW
Department of Allergy and Immunology, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Katial
R K
RK
Engler
R J
RJ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004342:Drug Hypersensitivity / Q000209:etiology*; D006561:Herpes Simplex / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage; D011339:Probenecid / Q000008:administration & dosage / Q000009:adverse effects*; D014528:Uricosuric Agents / Q000009:adverse effects*
D063065:Organophosphonates; D009943:Organophosphorus Compounds; D014528:Uricosuric Agents; D003596:Cytosine; D000077404:Cidofovir; D011339:Probenecid