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Revista Colombiana de Ciencias Químico - Farmacéuticas
Print version ISSN 0034-7418On-line version ISSN 1909-6356
Abstract
ARROYO MONTERROZA, Dadier Antonio; LOPEZ GARCIA, Raul Antonio and PINTO CAMACHO, Lisbeth Katlin. Hypersensitivity to trimethoprim + sulfamethoxazole in an Osteomyelitis desensitization-dosing schedule patient. Rev. colomb. cienc. quim. farm. [online]. 2022, vol.51, n.1, pp.89-99. Epub Dec 05, 2023. ISSN 0034-7418. https://doi.org/10.15446/rcciquifa.v51n1.102676.
Introduction:
Osteomyelitis is an inflammation of the bone tissue, which can be caused by a Gram-positive or Gram-negative infectious agent, generally caused by Staphylococcus aureus. This infection is usually treated with trimethoprim + sulfamethoxazole. Unfortunately, adverse drug reactions of the allergic type may appear during treatment, which would imply a change of antibiotic or subject the patient to a desensitization scheme.
Objective:
To report the case of a patient who underwent this scheme, using the intravenous route.
Results:
A 14-year-old male patient was admitted to the institution with osteomyelitis of the right tibia in his postoperative period of osteosynthesis performed two months earlier. It was decided to start treatment with TMP-SMX 300 mg intravenously (IV) every 12 hours. The patient and, since he was a minor, his dependent relative were informed about the importance of the procedure, possible risks and benefits through written informed consent. The patient presented a skin rash accompanied by itching on the chest and back. which was treated and resolved, therefore, the patient was submitted to the scheme for his desensitization, which was carried out using the medicine in injectable solution (trimethoprim + sulfamethoxazole 400 mg + 80 mg/5 mL) to continue his treatment, In addition, the patient was monitored and treatment with antihistamines or corticosteroids was not administered in order to avoid an erroneous response or false/positive results during the procedure.
Conclusion:
The patient was successfully desensitized to continue with his pharmacological treatment. This reported case can contribute to modify the current desensitization schemes; the desensitization scheme is a very useful tool to continue pharmacological treatment in patients with hypersensitivity to TMP/SMX, without the need to opt for other therapeutic alternatives that could be less effective for infection control.
Keywords : Osteomyelitis; hypersensitivity; trimethoprim + sulfamethoxazole; desensitization.