Bactrim for Son's Acne

[mariahul]

My 14 year old son has moderate acne without cysts. The PA in our dermatologist's office prescribed Bactrim DS bid for six weeks.  At the end of this time, he will evaluate him for Accutane.  I am very fearful of this drug due to the host of side effects that can be life threatening.  His skin is sensitive and becomes blotchy easily.  How will I know if he is experiencing a sulfa rash?  Have you ever encountered any of the severe effects in your pratice?  How long can one stay on this drug safely? Should his CBC and UA be monitored during therapy?  If so how often?  Initially they had him on Minocin and Differin, but when he developed  more skin blotchiness I stopped it.  He also uses Micro Retin A and benzoyl peroxide wash.  He has taken 3 doses of the Bactrim so far, and I am a nervous wreck.  I should also mention that his father is allergic to sulfa drugs.
Thanks for your help.

[jibberjabber]

I am 63 yrs. old.  I had small skin color bumps on the back of my R ankle for several yrs. I then developed red bumps on my legs and other body parts that itched and when scratched took a long time to heal.  In 7/06, I fell into a bush and developed a nasty skin condition there with the marks from the bush staying permanent.  My Fam. doc rx'd a cream and I believe an antibiotic.  I developed a severe itch on my legs and thighs & when I scratched it, it broke out in scabs.  It did not clear up so he rx'd Bactrim & to continue the cream.  About the 6th day of the bactrim I broke out in serious hives on my legs and arms and stopped the bactrim and cream immediately.  It took about 2 weeks for the hives to disappear.  I have since been to 2 dermatogists and am only using topical tx.  I believe the combination of the bactrim and the Clotrimazole & Betamethasone Dipropionate cream USP,1%/0.05% caused these hives.  So I would be careful of the medication combinations.

[Alan Rockoff, MD]

I don't think you need to be so concerned.  Sulfa is widely used for many conditions, like urinary track infections.  If no allergic rash happens in the next two weeks, then it's pretty sure that none will.  It's reasonable to try sulfa before moving on to Accutane, because it may make Accutane unnecessary.  Family history of drug allergy is not usually of much relevance.   If you see any symptoms that worry you, show a doctor.  Otherwise, relax.

Dr. Rockoff