Bactrim : Desensitization Protocol

Protocol 2

• Begin 9- to 13-day desensitization protocol, starting with pediatric oral suspension, which contains 40 mg of TMP and 200 mg of SMX per 5 mL (1 teaspoon). Gradually increase the dosage according to the protocol.
• If there is any concern about the severity of a previous reaction, have the patient take the initial morning dose in the clinic so that the patient may be monitored for 3-4 hours before going home. (This assumes that emergency treatment, including IV access materials, IV fluids, epinephrine, antihistamines, and steroids, are readily available.)
• Many experts recommend treatment with an antihistamine medication starting 1 day before initiation of the desensitization regimen and continuing daily until the dosage escalation is completed.
• More rapid desensitization protocols are available for patients urgently needing treatment with TMP-SMX.
• Use commercially available pediatric suspension (containing TMP 8 mg and SMX 40 mg per mL [40 mg/200 mg per 5 mL]), followed by double-strength tablets, as follows

https://aidsetc.org/guide/sulfa-desensitization#references

Protocol 3

Desensitization in delayed drug hypersensitivity reactions – an EAACI position paper of the Drug Allergy Interest Group. Allergy 2013; 68: 844–852.