很抱歉，今天一直没上网，没能及时回复您。

非常感谢您让我听到不同的声音。

• SULFA ALLERGY
  • Sulfonylureas contain a sulfonamide group in their structure
  • The sulfonamide group is different from the one that is found in sulfa-based antibiotics
  • Patients with a history of allergy to sulfa-based antibiotics may have a slight increase in risk of an allergic reaction to sulfonylureas
   
  • Cross-reactivity between sulfa-based antibiotics and sulfonamide nonantibiotics, NEJM (2003) [PubMed abstract]
    • A cohort study in the NEJM looked at the risk of an allergic reaction to nonantibiotic sulfonamides in patients who had a previous reaction to a sulfa-based antibiotic
    • The study found the following:
      • Patients with a history of sulfa-based antibiotic allergy who subsequently took nonantibiotic sulfonamides (including sulfonylureas) had a 10% risk of having a reaction to the nonantibiotic sulfonamide
      • In patients without a history of allergic reaction to a sulfa-based antibiotic, 1.6% had a reaction to a nonantibiotic sulfonamide
      • In addition, patients with a history of sulfa-based antibiotic allergy had a 14% chance of having a reaction to a penicillin antibiotic. This finding led researchers to conclude that a history of allergic reactions in general may be more predictive of a reaction than reactions to any specific medication [15]
  
  
  • StraightHealthcare analysis:
    • Sulfonylureas may be prescribed to patients with a history of sulfa-based antibiotic allergy
    • Patients should be aware that a cross-sensitivity reaction may occur with a risk of around 10%
    • Patients with a history of severe reactions to sulfa-based antibiotics should avoid nonantibiotic sulfonamides if they can. If not, then the initial dosing should be done under medical supervision.

如果交叉反应的危险度达到10%，并不是罕见。尤其是第二次给药，意味着我老公对Sulfonylureas过敏，就不应该再开Sulfonylureas药物。我老公服用25天才出现过敏反应，明显是IV型变态反应(迟发型变态反应），而不是I型变态反应。