Antibiotic prophylaxis in immunosuppressed patients - Missed opportunities from trimethoprim-sulfamethoxazole allergy label

© 2023 The Authors..

Trimethoprim-sulfamethoxazole (TMP-SMX) is a broad spectrum antibiotic in use for more than 50 years. It has an important indication as first line agent in the prophylaxis of opportunistic infections, particularly Pneumocystis jirovecii pneumonia (PJP), in immunosuppressed patients. For those who have a history of allergy or severe intolerance to TMP-SMX, pentamidine, dapsone or atovaquone may be substituted; however there is evidence that TMP-SMX offers superior coverage for PJP, toxoplasmosis, and nocardiosis. Compared to pentamidine, it has the added benefit of cost-effectiveness and self-administration as opposed to required hospital attendance for administration. Many patients who report a history of allergy or adverse reaction to TMP-SMX (or "sulfur allergy") will be found not to be allergic; and even those who are allergic may be able to be desensitized. The evaluation and, where appropriate, removal of TMP-SMX allergy label enables the use of TMP-SMX for prophylaxis against opportunistic infections. This is a cost-effective intervention to optimize antimicrobial prescribing and reduce the risk of opportunistic infections in immunosuppressed patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

The World Allergy Organization journal - 17(2024), 1 vom: 08. Jan., Seite 100856

Sprache:

Englisch

Beteiligte Personen:

Lee, Wei-I [VerfasserIn]
Lam, Lydia [VerfasserIn]
Bacchi, Stephen [VerfasserIn]
Jiang, Melinda [VerfasserIn]
Inglis, Joshua M [VerfasserIn]
Smith, William [VerfasserIn]
Hissaria, Pravin [VerfasserIn]

Links:

Volltext

Themen:

Co-trimoxazole
Drug allergy
Immunosuppression
Journal Article
PJP prophylaxis
Review
Trimethoprim-sulfamethoxazole

Anmerkungen:

Date Revised 19.01.2024

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.waojou.2023.100856

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367257726