Are there data to support fluconazole desensitization?
Fluconazole (Diflucan) is an azole antifungal indicated for the prophylaxis and treatment of various fungal infections.1 Although generally well tolerated, adverse effects of fluconazole therapy include hepatitis, leucopenia, thrombocytopenia, gastrointestinal distress, headache, anaphylaxis, and rash.2 Fluconazole-induced rashes range from mild, self-limiting reactions to life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Therapy is frequently discontinued when drug-induced reactions occur; however, in certain situations, a clinician may desire to continue treatment in order to optimize outcomes. In order to do so, desensitization protocols are often employed. For fluconazole, there are 3 published case reports involving patients who underwent desensitization following the occurrence of an adverse reaction.3-5 Craig and colleagues were the first to publish the successful use of a prolonged desensitization protocol (Table 1) in a 36 year old, H
