sulphonamides

introduction

sulfonamides are a group of bacteriostatic antibiotics originally called sulpha or sulfa tablets
they were the first antimicrobial drugs, and paved the way for the antibiotic revolution in medicine.
their use has been largely replaced by newer antibiotics with less adverse effects, but co-trimoxazole which contains sulfamethoxazole, is still used for urinary tract infections (UTIs) / cystitis, sinusitis, otitis media, acne vulgaris, etc.
new classes of medications such as sulphonylurea oral hypoglycaemics, Thiazide diuretics, sultiame, probenecid, sulfasalazine, sumatriptan, darunavir, and celecoxib are a non-antibiotic sulphonamides
3% develop allergy and hypersensitivity reactions, but interestingly up to 60% of those with HIV / AIDS develop reactions!
there is cross-sensitivity between antimicrobial sulphonamides but risk of cross-reactive hypersensitivity with the other sulphonamide classes appears to be low.

Prontosil, a prodrug, patented in 1933 after Bayer AG labs experimented with hundreds of dyes in the theory that these dyes may bind to bacteria and parasites and kill them.
- the first medicine ever discovered that could effectively treat a range of bacterial infections inside the body.
- it had a strong action against infections caused by streptococci, including blood infections, childbed fever, and erysipelas, and a lesser effect on infections caused by other cocci.
- it had no effect at all in-vitro, and thus was found to be a pro-drug and that the active metabolite was actually sulfanilamide which was free of patents and thus created a manufacturing craze with many forms being produced and marketed.
in 1937, the lack of testing requirements led to over 100 being poisoned by diethylene glycol in an elixir form which resulted in the passage of the Federal Food, Drug, and Cosmetic Act in 1938.
these drugs saved tens of thousands of lives during World War II, and was liberally used topically to prevent wound infections in soldier's first aid kits.