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Rapid Desensitisation of an Immunocompetent Patient with Cotrimoxazole Hypersensitivity
Author(s) -
Walton Natalie,
Krumins Daila
Publication year - 2010
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2010.tb00520.x
Subject(s) - medicine , rash , sulfamethoxazole , antibiotics , hypersensitivity reaction , trimethoprim , clearance , dermatology , intensive care unit , intensive care medicine , microbiology and biotechnology , urology , biology
Background Hypersensitivity reactions to cotrimoxazole (trimethoprim+sulfamethoxazole) are common. Limited and varied data are available on desensitisation protocols for patients with cotrimoxazole hypersensitivity. Aim To report the successful rapid desensitisation of an immunocompetent patient with cotrimoxazole hypersensitivity. Clinical Details A 58‐year‐old male presented with multiple brain abscesses of unknown origin on a background of actinomycotic lung lesions. He was admitted to the intensive care unit in a critical state and started on multiple antibiotics. After limited clinical improvement intravenous cotrimoxazole was initiated. Although the patient's clinical signs improved, he developed a rash. Cotrimoxazole was ceased and the rash cleared. Once the patient was clinically stable, cotrimoxazole desensitisation was attempted over 6 hours using the protocol from Therapeutic Guidelines: Antibiotic . Outcomes The patient was successfully desensitised and subsequently completed a 6‐month course of cotrimoxazole therapy. No further adverse reactions were reported. Conclusion Cotrimoxazole desensitisation using the protocol from Therapeutic Guidelines: Antibiotic can allow treatment of patients with sulfamethoxazole hypersensitivity.