Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
1986-6-25
pubmed:abstractText
In 1982, the fixed combination of pyrimethamine and sulfadoxine (Fansidar) became available in the United States, and was recommended for use in travelers at risk of acquiring chloroquine-resistant Plasmodium falciparum. Prior to that time, no reports of severe cutaneous reactions had appeared in the medical literature despite widespread use for more than 8 years in both Europe and malarious areas of the developing world. In the fall of 1984, the Centers for Disease Control received reports of 4 cases of toxic epidermal necrolysis (including 3 fatalities) among Americans who had used pyrimethamine-sulfadoxine (PYR/SDX) for the prevention of malaria. Subsequent investigation into severe cutaneous reactions associated with the use of this drug by American travelers detected 24 cases of erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis. Twenty-three of the 24 patients concurrently used chloroquine. Seven patients died. No risk factors in the development of these reactions other than the use of PYR/SDX could be identified. Among American travelers, we estimate that these reactions occur in 1 per 5,000-8,000 users, and that fatal reactions occur in 1 per 11,000-25,000 users. This higher than expected incidence necessitates that the use of PYR/SDX for the prevention of malaria be reconsidered. In the United States it is now recommended that the routine weekly use of the drug be reserved for those travelers at highest risk of acquiring chloroquine-resistant P. falciparum, when alternate prophylactic regimens are not deemed appropriate.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0002-9637
pubmed:author
pubmed:issnType
Print
pubmed:volume
35
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
451-8
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:2939735-Adolescent, pubmed-meshheading:2939735-Adult, pubmed-meshheading:2939735-Aged, pubmed-meshheading:2939735-Antimalarials, pubmed-meshheading:2939735-Child, pubmed-meshheading:2939735-Chloroquine, pubmed-meshheading:2939735-Drug Combinations, pubmed-meshheading:2939735-Drug Eruptions, pubmed-meshheading:2939735-Epidermal Necrolysis, Toxic, pubmed-meshheading:2939735-Erythema Multiforme, pubmed-meshheading:2939735-Female, pubmed-meshheading:2939735-Humans, pubmed-meshheading:2939735-Malaria, pubmed-meshheading:2939735-Male, pubmed-meshheading:2939735-Middle Aged, pubmed-meshheading:2939735-Plasmodium falciparum, pubmed-meshheading:2939735-Pyrimethamine, pubmed-meshheading:2939735-Stevens-Johnson Syndrome, pubmed-meshheading:2939735-Sulfadoxine, pubmed-meshheading:2939735-Sulfanilamides, pubmed-meshheading:2939735-Travel, pubmed-meshheading:2939735-United States
pubmed:year
1986
pubmed:articleTitle
Severe cutaneous reactions among American travelers using pyrimethamine-sulfadoxine (Fansidar) for malaria prophylaxis.
pubmed:publicationType
Journal Article