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Cited by 349Drug-Induced Adverse ReactionsPharmacovigilance and Adverse Drug ReactionsContact Dermatitis and Allergies

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.

Absence of Cross-Reactivity between Sulfonamide Antibiotics and Sulfonamide Nonantibiotics

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Strom, Brian L., Schinnar, Rita, Apter, Andrea J., Margolis, David J., Lautenbach, Ebbing, Hennessy, Sean, Bilker, Warren B., Pettitt, Dan·2003·New England Journal of Medicine
DOI 10.1056/nejmoa022963
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Abstract

BACKGROUND: The safety of sulfonamide nonantibiotics is unclear in patients with prior allergic reactions to sulfonamide antibiotics. METHODS: We conducted a retrospective cohort study using the General Practice Research Database in the United Kingdom, examining the risk of allergic reactions within 30 days after the receipt of a sulfonamide nonantibiotic. Patients with evidence of prior hypersensitivity after the receipt of a sulfonamide antibiotic were compared with those without such evidence. Similar analyses were also performed with the use of penicillins instead of sulfonamides, to determine whether any risk was specific to sulfonamide cross-reactivity. RESULTS: Of 969 patients with an allergic reaction after a sulfonamide antibiotic, 96 (9.9 percent) had an allergic reaction after subsequently receiving a sulfonamide nonantibiotic. Of 19,257 who had no allergic reaction after a sulfonamide antibiotic, 315 (1.6 percent) had an allergic reaction after receiving a sulfonamide nonantibiotic (adjusted odds ratio, 2.8; 95 percent confidence interval, 2.1 to 3.7). However, the risk of allergic reactions was even greater after the receipt of a penicillin among patients with a prior hypersensitivity reaction to a sulfonamide antibiotic, as compared with patients with no such history (adjusted odds ratio, 3.9; 95 percent confidence interval, 3.5 to 4.3). Furthermore, among those with a prior hypersensitivity reaction after the receipt of a sulfonamide antibiotic, the risk of an allergic reaction after the subsequent receipt of a sulfonamide nonantibiotic was lower than the risk of an allergic reaction after the subsequent receipt of a penicillin (adjusted odds ratio, 0.7; 95 percent confidence interval, 0.5 to 0.9). Finally, the risk of an allergic reaction after the receipt of a sulfonamide nonantibiotic was lower among patients with a history of hypersensitivity to sulfonamide antibiotics than among patients with a history of hypersensitivity to penicillins (adjusted odds ratio, 0.6; 95 percent confidence interval, 0.5 to 0.8). CONCLUSIONS: There is an association between hypersensitivity after the receipt of sulfonamide antibiotics and a subsequent allergic reaction after the receipt of a sulfonamide nonantibiotic, but this association appears to be due to a predisposition to allergic reactions rather than to cross-reactivity with sulfonamide-based drugs.

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Research works printed but not linked: 8

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Metadata

Authors
Strom, B. L., Schinnar, R., Apter, A. J., Margolis, D. J., Lautenbach, E., Hennessy, S., Bilker, W. B., & Pettitt, D.
Affiliations
  • University of Pennsylvania (US)
  • Pfizer (United States) (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2003-10-23
Volume
349
Issue
17
Pages
1628-1635
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa022963
OpenAlex
W2099552063
Cited by
349
References
34
Citations by year
2026: 14 · 2025: 11 · 2024: 15 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 13 · 2019: 18 · 2018: 17 · 2017: 18 · 2016: 12 · 2015: 12 · 2014: 12 · 2013: 23 · 2012: 14
FWCI
12.30
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
Keywords
sulfonamide antibiotics, drug cross-reactivity, drug hypersensitivity, allergic reactions, penicillin allergy, general practice patients, drug allergy testing
MeSH terms
Anti-Bacterial Agents, Cross Reactions, Diuretics, Drug Hypersensitivity, Humans, Retrospective Studies, Sulfonamides, Cohort Studies, Databases, Factual

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