Pharmacy World and Science

, Volume 20, Issue 6, pp 253–257

Managing drug reactions to sulfonamides and other drug in hiv infection: Desensitization rather than rechallenge

  • Peter P. Koopmans
  • David M. Burger

DOI: 10.1023/A:1008617019897

Cite this article as:
Koopmans, P.P. & Burger, D.M. Pharm World Sci (1998) 20: 253. doi:10.1023/A:1008617019897


Drug reactions in patients with hiv infection, e.g. fever or rash, are a frequently occurring clinical problem. These side effects particularly are observed with sulfonamides; however, many other drugs have also shown to induce allergic reactions when given to patients with hiv infection. The production of hydroxylamines has been put forward as one of the explanations for these high incidence of reactions on drugs. Since sulfonamides are the first choice of therapy for the treatment and prophylaxis of Pneumocystis carinii pneumonia, several strategies have been developed to circumvent drug reactions. In general rechallenge or desensitization are recommended in literature. This article discusses the results and risks of rechallenge and desensitization with sulfonamides or other drugs, as mentioned in the literature. Furthermore preliminary results of rechallenge with a sulfonamide, which is not metabolized into hydroxylamines, are presented. From the data in the literature it is concluded that desensitization should be preferred to rechallenge.

aids Antimicrobials Desensitization Drug reactions hiv-infection Hydroxylamines Rechallenge Sulfonamides Sulfametrol Side effects Cotrimoxazole 

Copyright information

© Kluwer Academic Publishers 1998

Authors and Affiliations

  • Peter P. Koopmans
    • 1
  • David M. Burger
    • 2
  1. 1.Department of General Internal MedicineUniversity Hospital Nijmegen St. RadboudNijmegenThe Netherlands
  2. 2.Department of Clinical PharmacyThe Netherlands

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