Successful Oral Desensitization to Trimethoprim-Sulfamethoxazole in Acquired Immune Deficiency Syndrome

Kalanadhabhatta, V; Muppidi, D; Sahni, Hemant; Robles, Ángel; Kramer, Martin

doi:10.1016/s1081-1206(10)63338-8

Cited by 27 publications

(3 citation statements)

References 33 publications

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“…Routes of administration that can be used in drug tolerance protocols include the oral, subcutaneous, and intravenous routes and even nasal or bronchial nebulization [26]. Good examples of the efficacy of these protocols have been reported in AIDS patients [27,28,29]. Although the mechanisms responsible for this tolerance to rush administration are unknown, it can be hypothesized that the mechanisms involved in conventional immunotherapy are subsequently activated, as illustrated by the marked increase of IgG4 production observed after 4 months in the present study.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of <i>Juniperus ashei</i> Sublingual-Swallow Ultra-Rush Pollen Immunotherapy in Cypress Rhinoconjunctivitis

Vervloët

Birnbaum

Laurent³

et al. 2006

Int Arch Allergy Immunol

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Background: The safety and efficacy of high-dose sublingual-swallow immunotherapy (SLIT) has been established in pollen rhinoconjunctivitis. This treatment has now been evaluated using an ultra-rush incremental dose regimen with a Juniperus ashei allergen extract in patients allergic to Cupressus sempervirens and Cupressus arizonica. Methods: Patients received either placebo or SLIT. Evaluation of safety was based on the frequency of adverse events during the incremental dose period (half a day) and during maintenance therapy (4 months). Evaluation of efficacy was based on symptom and medication scores at the pollen peak. Results: Seventy of the 76 patients included completed the study. There were no drop-outs during the rush procedure. One patient in the active group dropped out during the maintenance therapy due to adverse events: gastric pain and vomiting. There was also 1 drop-out in the placebo group due to pregnancy. Adverse events were infrequent, local and mild. Symptom scores for rhinitis and conjunctivitis were not statistically different between groups, but there was a marked and significant (p < 0.03) decrease of the medication score (about 50%) and nasal steroid consumption (about 75%) in the active treatment group. An increase from baseline of serum IgE and IgG4 J. ashei-specific antibodies was only observed in actively treated patients (p < 0.04 and p < 0.01, respectively). Conclusions: The tolerability and safety of high-dose ultra-rush SLIT were comparable to those reported in previous SLIT studies. SLIT with J. ashei extract, due to its high Jun a 1 content, significantly reduced nasal steroid consumption in patients allergic to European cypress.

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of <i>Juniperus ashei</i> Sublingual-Swallow Ultra-Rush Pollen Immunotherapy in Cypress Rhinoconjunctivitis

Vervloët

Birnbaum

Laurent³

et al. 2006

Int Arch Allergy Immunol

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“…Considerando los estudios realizados en los últimos 15 años con diferentes protocolos de desensibilización de cotrimoxazol, ha sido posible la readministración del antibiótico en aproximadamente dos tercios de los pacientes [14][15][16][17][18][19][20][21][22][23][24][25][26] . Los diversos protocolos de cotrimoxazol identificados en la revisión bibliográfica difieren entre ellos tanto en la vía de administración (oral o intravenosa) como en la duración del procedimiento.…”

Section: Resultados Revisión Bibliográficaunclassified

Desensibilización de cotrimoxazol, rifampicina y penicilina G en nueve pacientes con hipersensibilidad previa

Herranz

Massa

Tordera

et al. 2006

Farmacia Hospitalaria

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“…However, in the 1980s Sullivan published standardized protocols for antibiotic desensitization which increased safety and feasibility (Sullivan, 1982; Sullivan, 1994). Widespread use of sulfamethoxazole desensitization protocols emerged during the HIV epidemic in the 1990s (Absar et al, 1994; Kalanadhabhatta et al, 1996). In the 2000s, Castells described drug desensitizations for antibiotics, chemotherapeutic agents and monoclonal antibodies using standardized protocols, allowing for increased efficiency and an excellent safety profile (Brennan et al, 2009; Castells et al, 2008; Liu et al, 2011).…”

Section: What Are Drug Desensitizations?mentioning

confidence: 99%

Safe administration of drug desensitizations in pediatric patients

Herr

Ferdman

Braskett

2020

Specialist Pediatric Nursing

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Purpose Patients with certain types of allergic reactions to medication may safely receive the culprit medication through an elaborate allergy procedure called a drug desensitization. Nurses play a key role in this process which is only performed when a certain medication is absolutely indicated as optimal therapy. Nurses are instrumental in the planning stages of drug desensitizations for coordination of interdisciplinary care and anticipation of adverse effects. Thus, it is paramount that nurses performing this procedure understand the mechanism of desensitizations and have access to the resources needed to safely complete these procedures in pediatric patients. Conclusion Excellence in nursing clinical acumen and a detailed order set are essential to patient safety during dug desensitization. With the following methodology and coordination by nursing, we have had great success at Children's Hospital Los Angeles in over one hundred drug desensitizations in pediatric patients which allowed them to received first line therapies. We have created order sets from published references and years of clinical experience. The nursing care of adult patients undergoing drug desensitization procedures is well described in the literature but few resources exist for pediatric nurses. There is paucity of published nursing resources for pediatric drug desensitizations. Repeated PubMed searches for “pediatric drug desensitizations” in 2019‐2020, revealed only one recent reference geared toward physicians. Practice Implications With appropriate training, staffing, and coordination, drug desensitizations can be safely performed in pediatric patients with close observation by a multi‐disciplinary team. The bedside nurse has a pivotal role as coordinator and clinician for these high‐risk resource‐intensive procedures.

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Successful Oral Desensitization to Trimethoprim-Sulfamethoxazole in Acquired Immune Deficiency Syndrome

Cited by 27 publications

References 33 publications

Safety and Efficacy of <i>Juniperus ashei</i> Sublingual-Swallow Ultra-Rush Pollen Immunotherapy in Cypress Rhinoconjunctivitis

Safety and Efficacy of <i>Juniperus ashei</i> Sublingual-Swallow Ultra-Rush Pollen Immunotherapy in Cypress Rhinoconjunctivitis

Desensibilización de cotrimoxazol, rifampicina y penicilina G en nueve pacientes con hipersensibilidad previa

Safe administration of drug desensitizations in pediatric patients

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