Title: Cross-reactivity Between Sulfonamide Antimicrobials and Non-Antimicrobials
题目：磺胺类的抗菌素和非抗菌素之间的交叉反应
Author 作者: Bryan Hayes

Patients frequently report having a sulfa allergy. In most cases, the allergic reaction was secondary to a sulfonamide antimicrobial agent, such as sulfamethoxazole-trimethoprim.
经常会有病人有对磺胺过敏。多数情况下是对磺胺类抗菌素有过敏反应，如磺胺甲基异恶唑-甲氧苄氨嘧啶（复方新诺明）。
The question is: Can I use furosemide (or other non-antimicrobial agents containing a sulfa component)?
问题式：我可以用速尿（或其它非抗菌素类磺胺制剂）吗？
There is minimal evidence of cross-reactivity between sulfonamide antimicrobials and non-antimicrobials.
几乎没有证据证实磺胺类的抗菌素和非抗菌素之间有交叉反应。
Despite this, the U.S. FDA-approved product information for many non-antimicrobial sulfonamide drugs contains warnings concerning possible cross-reactions.
尽管如此，在美国药物和食物管理局批准的非抗菌素磺胺类药品说明书中，还是有可能有交叉危险的警示。
Bottom line: If a patient had a true IgE-mediated anaphylactic reaction to a sulfonamide antimicrobial, it may be best to avoid other sulfa-related medications (use ethacrynic acid if a loop diuretic is needed). Otherwise, the available literature does not support cross-reactivity between sulfonamide antimicrobials and non-antimicrobials.
结论：如果病人确实有IgE导致的对磺胺类抗菌素过敏反应，最好避免任何其它含磺胺类的药物（如必须用环利尿剂，可用依他尼酸，利尿酸）。到目前为止还没有证据证实磺胺类的抗菌素和非抗菌素之间有交叉反应。

References 参考文献
Strom BL, et al. Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics. N Engl J Med 2003;349(17):1628-1635.


Hemstreet BA, et al. Sulfonamide allergies and outcomes related to use of potentially cross-reactive drugs in hospitalized patients. Pharmacother 2006;26(4):551-557.


Lee AG, et al. Presumed "sulfa allergy" in patients with intracranial hypertension treated with acetazolamide or furosemide: cross-reactivity, myth or reality? Am J Ophthalmol 2004;138(1):114-118.

Johnson KK, et al. Sulfonamide cross-reactivity: fact or fiction? Ann Pharmacother 2005;39(2):290-301.