Dermatologic Manifestations of Job Syndrome Medication

Updated: Mar 30, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
  • Print
Medication

Medication Summary

The goals of pharmacotherapy for Job syndrome (HIE syndrome, or hyper-IgE syndrome) are to eradicate infections, reduce the morbidity rate, and prevent complications.

Next:

Antimicrobials

Class Summary

Therapy must be comprehensive and cover all likely pathogens in the context of the clinical setting.

Nafcillin (Nafcil, Unipen, Nallpen)

Nafcillin is initial therapy for suspected penicillin G-resistant streptococcal or staphylococcal infections. Because of thrombophlebitis, particularly in elderly patients, administer nafcillin parenterally for only a short term (1-2 d); change to the oral route as clinically indicated. Use for the treatment of pulmonary and cutaneous infections.

Oxacillin (Bactocill, Prostaphlin)

Oxacillin is a bactericidal antibiotic that inhibits cell wall synthesis. It is used in the treatment of infections caused by penicillinase-producing staphylococci. It may be used to initiate therapy in suspected staphylococcal infection. Use this agent for the treatment of pulmonary and cutaneous infections.

Ampicillin (Marcillin, Omnipen, Polycillin, Principen, Totacillin)

Ampicillin has bactericidal activity against susceptible organisms. Use it to treat pulmonary and cutaneous infections.

Vancomycin (Lyphocin, Vancocin, Vancoled)

Vancomycin is a potent antibiotic directed against gram-positive organisms and active against Enterococcus species. It is useful in the treatment of septicemia and skin structure infections. Vancomycin is indicated for use in patients who cannot receive penicillins and cephalosporins, those whose disease did not respond to these drugs, and those who have infections with resistant staphylococci. To avoid toxicity, the current recommendation is to assay vancomycin trough levels after the third dose, with sample drawn 0.5 hour prior to the next dose. Use creatinine clearance to adjust the dose in renal impairment. Use it for the treatment of pulmonary and cutaneous infections.

Cefazolin (Ancef, Kefzol, Zolicef)

Cefazolin is a first-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth. It is primarily active against skin flora, including S aureus. Cefazolin is typically used alone for skin and skin-structure coverage. Intravenous and intramuscular dosing regimens are similar. Use it for the treatment of pulmonary and cutaneous infections.

Sulfamethoxazole and trimethoprim (Bactrim, Bactrim DS)

This combination inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. It is used for the prevention and/or suppression of inflammatory symptoms of Job syndrome.

Cyclosporine (Sandimmune, Neoral)

Cyclosporine is helpful in a variety of skin disorders. It is used for the prevention and/or suppression of inflammatory symptoms of Job syndrome.

Previous
Next:

Antifungals

Class Summary

Their mechanism of action may involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to the fungal cell.

Fluconazole (Diflucan)

Fluconazole has fungistatic activity. It is a synthetic oral antifungal (broad-spectrum bistriazole) that selectively inhibits fungal cytochrome P-450 and sterol C-14 alpha-demethylation, preventing the conversion of lanosterol to ergosterol and thereby disrupting cellular membranes. It is used for the treatment of fungal infections in Job syndrome, including onychomycosis.

Ketoconazole (Nizoral)

Ketoconazole has fungistatic activity. It is an imidazole broad-spectrum antifungal agent; it inhibits the synthesis of ergosterol, causing cellular components to leak and resulting in fungal cell death. Ketoconazole is used for the treatment of fungal infections in Job syndrome, including onychomycosis.

Previous