HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Efficacy and safety of rechallenge with low-dose trimethoprim-sulphamethoxazole in previously hypersensitive HIV-infected patients.

AbstractOBJECTIVE:
This study was undertaken to determine whether patients infected with HIV and with prior hypersensitivity to trimethoprim-sulphamethoxazole (TMP-SMX) can be rechallenged successfully with TMP-SMX, what factors predict successful rechallenge, and whether hypersensitivity is due to TMP or to SMX.
DESIGN:
A prospective, open study.
SETTING:
A tertiary referral hospital.
PATIENT:
Thirty-one HIV-infected patients with a history of non-life-threatening hypersensitivity to TMP-SMX.
INTERVENTIONS:
Patients received TMP (300 mg twice a week) for 2 weeks and, where no major reaction occurred, subsequently with TMP-SMX (160 and 800 mg per tablet, one tablet two times a day, twice a week). Patients who developed significant and persistent hypersensitivity ceased SMX and were subsequently challenged with TMP-dapsone (300 and 100 mg, respectively, twice a week).
MAIN OUTCOME MEASURES:
That rechallenge is more likely to be successful in those with advanced HIV disease.
RESULTS:
Five out of 31 (16%) patients developed hypersensitivity to TMP, and two ceased TMP as a result. Fifteen of the 26 (58%) patients who received subsequent TMP-SMX developed hypersensitivity, 12 of whom ceased TMP-SMX because of this reaction. Hypersensitivity to TMP-SMX was significantly less common in those with a CD4+ cell count < 20 x 10(6)/l than in those with a CD4+ cell count > 20 x 10(6)/l (31 versus 85%; P = 0.03). Hypersensitivity to TMP-dapsone occurred in two out of nine patients with hypersensitivity to TMP-SMX on rechallenge. One patient developed transient dyspnoea following a dose of SMX, but no other serious adverse drug reaction occurred.
CONCLUSIONS:
Rechallenge with TMP-SMX appears safe in HIV-infected patients with a history of non-life-threatening hypersensitivity and is most likely to be successful in patients with a low CD4+ lymphocyte count. The data suggest a low rate cross-hypersensitivity between SMX and dapsone, at least at the doses used.
AuthorsA Carr, R Penny, D A Cooper
JournalAIDS (London, England) (AIDS) Vol. 7 Issue 1 Pg. 65-71 (Jan 1993) ISSN: 0269-9370 [Print] England
PMID8442919 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Trimethoprim, Sulfamethoxazole Drug Combination
Topics
  • AIDS-Related Opportunistic Infections (prevention & control)
  • Adult
  • Cross Reactions
  • Drug Eruptions (complications, etiology, immunology)
  • Drug Hypersensitivity (complications, etiology, immunology)
  • HIV Infections (complications, drug therapy)
  • Humans
  • Male
  • Pneumocystis Infections (prevention & control)
  • Safety
  • Trimethoprim, Sulfamethoxazole Drug Combination (administration & dosage, adverse effects, immunology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: