A Comprehensive Review of Sulfonamide Hypersensitivity: Implications for Clinical Practice.

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2023-12-01 Epub Date: 2024-01-04 DOI:10.1007/s12016-023-08978-w
Bruno Serrano-Arias, Adriana Araya-Zúñiga, Johan Waterhouse-Garbanzo, Zoe Rojas-Barrantes, Sebastián Arguedas-Chacón, Esteban Zavaleta-Monestel
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Abstract

Sulfonamides, which are drugs commonly prescribed in hospital and outpatient settings, have historically been associated with a high incidence of hypersensitivity reactions. It is believed that there is an increased risk of cross-reactions with other drugs that contain this functional group in their structure. However, it has not been conclusively established that the sulfonamide group is the sole cause of hypersensitivity reactions, as non-antibiotic sulfonamides do not share the same accessory groups with antibiotic sulfonamides. Therefore, cross-reactivity between different types of sulfonamides and sulfonamide-type antibiotics is not clearly demonstrated, and allergic reactions may involve other mechanisms. Misinformation about this topic can lead to inappropriate use of alternative antibiotics with lower efficacy or higher adverse effects, contributing to antibiotic resistance. It is crucial to individualize and monitor patients with a history of allergies to sulfonamide-type antibiotics when introducing a new drug containing sulfa and manage any adverse reactions promptly. Desensitization protocols may be a viable option for patients who specifically benefit from these antibiotics, particularly those who are immunosuppressed. This article provides a descriptive bibliographic review to update information on sulfa allergy, its prevalence, management, and recommendations to prevent such reactions and optimize pharmacotherapy, without underusing these drugs.

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磺胺类药物过敏性综合评述:对临床实践的意义。
磺胺类药物是医院和门诊的常用处方药,历来与超敏反应的高发生率有关。一般认为,磺胺类药物与其他结构中含有该官能团的药物发生交叉反应的风险会增加。然而,磺酰胺基团是导致超敏反应的唯一原因这一点尚未得到确证,因为非抗生素磺酰胺类药物与抗生素磺酰胺类药物不具有相同的附属基团。因此,不同类型的磺胺类药物与磺胺类抗生素之间的交叉反应并未得到明确证实,过敏反应可能涉及其他机制。有关这一主题的错误信息可能会导致不恰当地使用疗效较差或不良反应较高的替代抗生素,从而助长抗生素耐药性。在引入含磺胺类抗生素的新药时,必须对有磺胺类抗生素过敏史的患者进行个体化治疗和监测,并及时处理任何不良反应。对于特别受益于这些抗生素的患者,尤其是免疫抑制患者,脱敏方案可能是一种可行的选择。本文通过描述性文献综述更新了有关磺胺过敏、其发病率、处理方法以及预防此类反应和优化药物治疗的建议等方面的信息,同时也避免了对这些药物的滥用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
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