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Sulfa drugs okay for people with antibiotic allergy
By Anthony J. Brown, MD
Last Updated: 2003-10-22 16:55:15 -0400 (Reuters Health)
NEW YORK (Reuters Health) - If you've been told you're allergic to sulfa antibiotics, it does not necessarily mean you need to avoid using other sulfa drugs, new research suggests.
As it turns out, such patients seem to be at risk for allergic reactions to any subsequent drug, not just sulfa drugs. In fact, they are at even higher risk for reactions to penicillins than to sulfa drugs.
Sulfa drugs are so-named because they contain a form of sulfur. In addition to several antibiotics, a variety of popular drugs, such as Lasix and Celebrex, are considered sulfa drugs.
The new findings, which are reported in The New England Journal of Medicine, are based on a study of more than 20,000 subjects in the UK who were evaluated for allergic reactions within 30 days of receiving a non-antibiotic sulfa drug. Nearly 1000 of the subjects had an allergy to sulfa antibiotics.
Subjects with the allergy were nearly three times more likely than others to experience a reaction to other sulfa drugs, lead author Dr. Brian L. Strom, from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues note.
However, the increased risk of reactions in the allergy group was even more pronounced with non-sulfa drugs. For example, an allergy to sulfa antibiotics raised the risk of reaction to penicillin by 3.9-fold compared with not having this allergy. In addition, patients with this allergy were 30 percent less likely to react to other sulfa drugs than to penicillin.
The authors also found that the risk of reaction to sulfa drugs was actually higher in patients with a history of penicillin allergy than among patients allergic to sulfa antibiotics.
All of these findings suggest that an allergy to sulfa antibiotics doesn't raise the risk of allergy to other sulfa drugs per se, Strom told Reuters Health.
"If somebody is allergic to a sulfa antibiotic, they are at risk for allergic reaction to any subsequent drug," he noted. "However, they are not at unique risk for reaction to a sulfa-based drug."
"The message for (doctors) is that patients with an allergy to sulfa antibiotics do not need to be steered away from sulfa-based drugs," Strom emphasized.
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