Cross-reactivity in HIV-infected patients switched from trimethoprim-sulfamethoxazole to dapsone.
OBJECTIVE
To evaluate the cross-reactivity of dapsone after a documented hypersensitivity reaction to trimethoprim-sulfamethoxazole (TMP-SMX) during prophylaxis for Pneumocystis carinii pneumonia.


METHODS
Retrospective, chart review, cohort study.


METHODS
Two university-affiliated teaching hospitals.


METHODS
Sixty patients infected with the human immunodeficiency virus.


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.
Holtzer
C D
CD
AIDS Program, San Francisco General Hospital, CA 94110, USA.
Flaherty
J F
JF
Coleman
R L
RL
D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000187:drug effects; D015331:Cohort Studies; D003429:Cross Reactions; D003622:Dapsone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000209:etiology; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000139:chemically induced; D012189:Retrospective Studies; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014581:Urticaria / Q000139:chemically induced
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003622:Dapsone