Sulfonamides, particularly antimicrobial sulfonamides, have been implicated as a common cause of a spectrum of hypersensitivity reactions. Immediate IgE-mediated reactions have been reported but are much less common than delayed cutaneous reactions. Delayed cutaneous reactions range from benign exanthems to severe cutaneous reactions such as Stevens Johnson syndrome, toxic epidermal necrolysis, or drug reaction with eosinophilia and systemic symptoms. Sulfonamides can be subclassified as antimicrobial sulfonamides and non-antimicrobial sulfonamides, which are also distinguished by key structural differences, resulting in very low risk of cross-reactivity between these two subclasses. Immediate and delayed skin testing and in vitro testing remain limited as options in evaluating antimicrobial sulfonamide hypersensitivity. Drug challenges continue to play an important role in the evaluation of both immediate and delayed reactions, with a growing body of evidence for the safety of direct challenges regardless of human immunodeficiency virus infection status. While numerous “desensitization” protocols have been described for the management of antimicrobial sulfonamide hypersensitivity, there is limited evidence that such procedures are successful because of an induction of tolerance.

磺胺类药物，特别是抗微生物磺胺类药物，已被认为是一系列超敏反应的常见原因。已经报道了立即 IgE 介导的反应，但比延迟皮肤反应少得多。迟发性皮肤反应的范围从良性皮疹到严重的皮肤反应，如 Stevens Johnson 综合征、中毒性表皮坏死松解症，或嗜酸性粒细胞增多和全身症状的药物反应。磺胺类药物可细分为抗微生物磺胺类药物和非抗微生物磺胺类药物，它们的区别也在于关键的结构差异，因此这两个亚类之间的交叉反应风险非常低。立即和延迟皮肤试验和体外试验作为评估抗菌磺胺超敏反应的选择仍然有限。药物挑战在评估即时和延迟反应方面继续发挥重要作用，越来越多的证据表明直接挑战的安全性，无论人类免疫缺陷病毒感染状态如何。虽然已经描述了许多“脱敏”方案来管理抗菌磺胺超敏反应，但由于诱导耐受性，这些程序成功的证据有限。