RAPID ORAL DESENSITIZATION TO TRIMETHOPRIM-SULFAMETHOXAZOLE IN INFANTS AND CHILDREN

Background, Although trimethoprim-sulfamethoxazole is the preferred ch emoprophylaxis against Pneumocystis carinii pneumonia, there are frequ ent IgE-mediated reactions among children infected with the human immu nodeficiency virus (HIV), Oral desensitization allows more patients to receive chemoprophylaxis, but it has been studied in only a limited n umber of children, Methods, We desensitized five children infected wit h the HIV using a rapid, 4-h oral protocol. Results, Three children (i ncluding two infants) successfully completed desensitization and start ed maintenance therapy, but the other two experienced reactions that p recluded further administration of trimethoprim-sulfamethoxazole. Conc lusions. We conclude that a rapid, oral trimethoprim-sulfamethoxazole desensitization protocol is safe and, in some instances, effective amo ng HIV-infected children and infants with a history of non-life-threat ening, IgE-mediated reactions to trimethoprim-sulfamethoxazole.