Renal Impairment Associated With Trimethoprim-Sulfamethoxazole Use in the Pediatric Population.
acute kidney injury
anemia
anti-bacterial agents
hyperkalemia
sulfamethoxazole-trimethoprim
Journal
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
ISSN: 1551-6776
Titre abrégé: J Pediatr Pharmacol Ther
Pays: United States
ID NLM: 101089851
Informations de publication
Date de publication:
2022
2022
Historique:
received:
06
07
2021
accepted:
19
01
2022
entrez:
3
10
2022
pubmed:
4
10
2022
medline:
4
10
2022
Statut:
ppublish
Résumé
Limited studies describe acute kidney injury (AKI) in children receiving trimethoprimsulfamethoxazole (SXT). The primary objective of this study was to describe AKI with SXT use in pediatric patients. Secondary objectives included describing the incidence of hyperkalemia and blood dyscrasias with SXT use. In this retrospective, single-center observational study, inpatient electronic medical records were reviewed for patients younger than 18 years of age who received at least 5 days of SXT for treatment of a bacterial infection. Patients were excluded if serum creatinine data prior to and after initiation of SXT were unavailable, they had AKI or were on hemodialysis prior to SXT initiation, or they were admitted to an oncology unit. Of 98 patients who met inclusion criteria, 24 (24.5%) experienced stage I AKI and 16 (16.3%) experienced stage II or III AKI. The mean treatment duration with SXT at time of AKI development was 5.9 days. Coadministration of SXT with other nephrotoxic medications increased the risk of development of AKI (OR, 1.7; 95% CI, 1.2-2.4). Hyperkalemia was noted in 29 patients (29.6%), anemia in 39 patients (39.8%), thrombocytopenia in 30 (30.6%), and neutropenia in 39 (39.8%). Changes in renal function suggestive of AKI occur frequently in pediatric patients receiving at least 5 days of treatment with SXT, particularly when using serum creatinine as a marker of AKI. In contrast, when using urine output rather than serum creatinine, the incidence is much lower and may be more reflective of a true change in renal function. Coadministration of nephrotoxic agents increases the risk of development of AKI. Anemia and hyperkalemia are common in patients receiving SXT and not associated with development of AKI. Further prospective study is warranted to validate these results.
Identifiants
pubmed: 36186241
doi: 10.5863/1551-6776-27.7.663
pmc: PMC9514763
doi:
Types de publication
Journal Article
Langues
eng
Pagination
663-668Informations de copyright
Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membership@pediatricpharmacy.org 2022.
Déclaration de conflit d'intérêts
Disclosures. The authors declare no conflicts.
Références
J Pediatr Hematol Oncol. 2017 Apr;39(3):194-202
pubmed: 28267082
Drugs. 1982 Jun;23(6):405-30
pubmed: 7049657
J Clin Pharm Ther. 2022 Sep;47(9):1409-1417
pubmed: 35545234
Clin Infect Dis. 2011 Oct;53(7):e25-76
pubmed: 21880587
Crit Care. 2007;11(2):R31
pubmed: 17331245
Ann Pharmacother. 2013 Dec;47(12):1618-26
pubmed: 24259630
Ann Pharmacother. 2020 Sep;54(9):852-857
pubmed: 32106685
J Antimicrob Chemother. 2012 May;67(5):1271-7
pubmed: 22351681
J Urol. 1975 Dec;114(6):802-8
pubmed: 1195454
J Intern Med. 1990 Oct;228(4):353-60
pubmed: 2266345
Clin J Am Soc Nephrol. 2011 Apr;6(4):856-63
pubmed: 21212419
Rev Infect Dis. 1982 Mar-Apr;4(2):429-33
pubmed: 7051241
Lancet. 1978 Feb 4;1(8058):244-5
pubmed: 74667
Front Pediatr. 2020 Jan 21;7:565
pubmed: 32039121
Lancet. 1973 Feb 24;1(7800):394-7
pubmed: 4119706
J Renal Inj Prev. 2015 Sep 01;4(3):57-60
pubmed: 26468475
BMJ. 2018 Feb 9;360:k341
pubmed: 29438980
J Pediatr. 1985 Jun;106(6):995-1000
pubmed: 3889261
Arch Intern Med. 2003 Feb 24;163(4):402-10
pubmed: 12588198
Nephron Clin Pract. 2011;119(3):c187-93; discussion c193-4
pubmed: 21832843
J Pediatr Gastroenterol Nutr. 2018 Aug;67(2):292-310
pubmed: 30044358
Ther Drug Monit. 1982;4(1):77-9
pubmed: 7071907
Nephron Clin Pract. 2012;120(4):c179-84
pubmed: 22890468
Am J Dis Child. 1981 Dec;135(12):1100-3
pubmed: 7315805
Pediatr Infect Dis J. 1997 Nov;16(11):1028-31
pubmed: 9384334
Chemotherapy. 1981;27(4):229-32
pubmed: 6788457