Common antibiotic can have serious adverse reactions

trimethoprim-sulfamethoxazole – that has been used since 1968 can cause serious adverse reactions and physicians need to be aware of these in prescribing, states a review in CMAJ (Canadian Medical Association Journal).

Trimethoprim–sulfamethoxazole is the most commonly prescribed antibiotic for urinary tract infections in Canada, and is used to treat community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and other bacterial infections. The drug, which is low-cost and effective, is used by hundreds of thousands of Canadians each year, with about 4000 prescriptions each week in Ontario alone.

However, it can cause adverse reactions, some that can be life-threatening, as well as kidney effects (hyperkalemia) and hypoglycemia, which are common results of drug interactions.

"Although trimethoprim-sulfamethoxazole has numerous benefits, particularly in the care of patients with HIV and methicillin-resistant S. aureus, it is associated with multiple toxicities," write the authors. "However, all drugs carry adverse effects. When considering other antimicrobials, clinicians should remember that areas of uncertainty remain, particularly with newer agents."

To help physicians to remember the various possible toxic reactions, the authors propose the NOT RISKY acronym as an aid. They also suggest ways to reduce the risk of –sulfamethoxazole, such as using an alternative antibiotic, especially in pregnant women, and monitoring for kidney issues and hypoglycemia in patients on the drug.

"Clinicians should be cognizant of the potential consequences of prescribing trimethoprim–sulfamethoxazole, monitor for adverse events during therapy or use an alternate antibiotic when appropriate," the authors conclude.

add to favorites email to friend print save as pdf

Related Stories

High potassium? Check your antibiotic

Jul 01, 2010

Older adults taking the antibiotic combination trimethoprim-sulfamethoxazole (TMP-SMX)—widely prescribed for urinary tract infections—are at increased risk of elevated potassium levels, called hyperkalemia, according ...

MRSA head and neck infections increase among children

Jan 19, 2009

Rates of antibiotic-resistant head and neck infections increased in pediatric patients nationwide between 2001 and 2006, according to a report in the January issue of Archives of Otolaryngology-Head & Neck Surgery, one of ...

Recommended for you

Study recalculates costs of combination vaccines

Apr 17, 2014

One of the most popular vaccine brands for children may not be the most cost-effective choice. And doctors may be overlooking some cost factors when choosing vaccines, driving the market toward what is actually a more expensive ...

Drug watchdog urges vigilance in cancer drug theft

Apr 17, 2014

Europe's medicine watchdog urged doctors Thursday to be vigilant in administering the cancer drug Herceptin, vials of which had been stolen in Italy and tampered with before being sold back into the supply chain.

User comments