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Allergies to sulfonamide antibiotics (e.g., sulfamethoxazole-trimethoprim [TMP-SMX]) are notorious for causing drug hypersensitivity reactions; as many as 8% of hospitalized patients report sulfa-related adverse events. Patients can have immediate or delayed reactions, ranging from mild exanthems to life-threatening Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Researchers adapted PEN-FAST, a scoring tool originally created for penicillin allergy (NEJM JW Gen Med Apr 15 2020 and JAMA Intern Med 2020; 180:745), to risk stratify 320 U.S. and Australian patients with previous TMP-SMX reactions.
PEN-FAST (SULF-FAST) criteria are as follows:
Allergy event occurred ≤5 years ago (2 points)
Allergy event was anaphylaxis/angioedema or …