We present a case report of APS that developed several days after taking trimethoprim/sulfamethoxazole. The clinical and pathological features of this unique presentation, differential diagnoses, and treatments are discussed. [ncbi.nlm.nih.gov]

• Anemia

  Utilizing the Naranjo adverse drug reaction probability scale, there is a probable association between the patient's hemolytic anemia and TMP-SMX. CONCLUSION: We report a case of hemolytic anemia resulting from the use of TMP-SMX. [ncbi.nlm.nih.gov]

  Adverse Effects: GI – nausea, vomiting Hematologic – pancytopenia, agranulocytosis, macrocytic anemia, thrombocytopenia Skin – toxic erythema, erythema nodosum, fixed local eruption, erythema multiforme, Lyell’s syndrome, Exfoliative dermatitis, urticaria [antimicrobe.org]

  Difficile diarrhea Primsol may cause anemia due to a deficiency of folic acid. The anemia usually is mild and resolves when the Primsol is stopped. [medicinenet.com]

• Weakness

  confusion, achy, stiff, or uncoordinated muscles) symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea) unusual tiredness or weakness Stop taking the medication and seek immediate [chealth.canoe.com]

• Fatigue

  Infected animals may transmit Q... 7 Reasons You Are Tired After Surgery Postsurgical fatigue is normal and is due to a variety of factors. Depression, stress, and anxiety may produce fatigue. Sleep... [medicinenet.com]

  […] blisters, itching /swelling (especially of the face/ tongue /throat), persistent sore throat or fever, paleness, joint pain /aches, persistent cough, trouble breathing, easy bleeding/bruising, yellowing eyes or skin, persistent nausea / vomiting, unusual fatigue [webmd.com]

  […] weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools) symptoms of low sodium in the blood (e.g., tiredness, weakness, confusion, achy, stiff, or uncoordinated muscles) symptoms of too much potassium in the body (e.g., muscle fatigue [chealth.canoe.com]

• Asymptomatic

  It is used to treat recurrent cystitis, mild acute prostatitis, urinary tract infections, asymptomatic bacteriuria during pregnancy and respiratory tract infections. [toku-e.com]

  It is used to treat urinary tract infections, mild acute prostatitis, recurrent cystitis, asymptomatic bacteriuria during pregnancy and respiratory tract infections. [sigmaaldrich.com]

  The aim of this study is to evaluate the influence of TMP-SMX prophylaxis on the occurrence of asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) as cystitis and allograft pyelonephritis (AGPN) and its impact on the antimicrobial resistance [ncbi.nlm.nih.gov]

• Inflammation

  Abstract There is often overlap in the diagnostic features of common pathologic processes such as infection, sterile inflammation, and cancer both clinically and using conventional imaging techniques. [ncbi.nlm.nih.gov]

  Silveira 2002 stated that the severity of inflammation was higher in the control group but did not provide further details. [doi.org]

  Inflammation of salivary glands causing facial pain Inflammation of the pancreas causing severe abdominal pain Cystitis bladder infections are caused by bacteria and need to be treated with antibiotics. [zavamed.com]

  Ear Infection (Otitis Media) Middle ear infection or inflammation (otitis media) is inflammation of the middle ear. There are two forms of this type of ear... [medicinenet.com]

• Pneumonia

  Abstract The global emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae poses a major public health threat requiring immediate and aggressive action. [ncbi.nlm.nih.gov]

  Although high doses of TMP-SMZ may have some antibacterial effect on Mycoplasma pneumoniae, Chlamydia pneumoniae, and Chlamydia trachomatis, they are considered to be clinically resistant to TMP-SMZ. [doi.org]

  Pneumocystis Carinii Pneumonia Prevention, Proteus Urinary Tract Infection, Streptococcus Acute Otitis Media, Streptococcus Pneumoniae Chronic Bronchitis Additionally, unlabeled uses include: [5] Acquired Immunodeficiency Syndrome with Toxoplasmosis [sourcewatch.org]

• Sore Throat

  Other ingredients: Lactose monohydrate Povidone Crospovidone Sodium starch glycollate (type A) Magnesium stearate Nausea Vomiting Diarrhoea Skin rashes Urticaria Anaemia Sore throat Mouth ulcers Thrush Irregular heartbeat caused by high levels of potassium [dred.com]

  Nausea and occasionally vomiting Headache Loose stools Sore throat or persistent cold Joint pains Rashes Rarely - diarrhoea Rarely - Dizziness and drowsiness. Do not drive or operate machinery under these circumstances. [zavamed.com]

  Tell your doctor right away if you have any serious side effects, including: signs of infection (such as fever, persistent sore throat ), easy bruising/bleeding, unusual paleness, mental/mood changes, tiredness with fast/pounding/irregular heartbeat, [webmd.com]

  […] pain, tired feeling, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that [uofmhealth.org]

• Pharyngitis

  TMP/SMX is not clinically effective for group A streptococcal pharyngitis. [merckmanuals.com]

  […] which may cause difficulty in swallowing or breathing wheezing or shortness of breath. you have severe liver or kidney disease, any blood disorder or megaloblastic anaemia the child you are treating is less than 3 months of age you have streptococcal pharyngitis [news-medical.net]

  Because of this uncertainty, and because more-effective antimicrobial agents exist, TMP-SMZ is not considered the drug of choice for the treatment of patients with pharyngitis or skin infections caused by S. pyogenes. [doi.org]

• Loss of Appetite

  Some of the common side effects include, but are not limited to: Nausea Vomiting Loss of appetite Rashes Itching. [bacteria.emedtv.com]

  […] fever, muscle pain Uneven heartbeat, numbness or tingling in your hands, feet, or lips Unusual bleeding, bruising, or weakness If you notice these less serious side effects, talk with your doctor: Mild nausea, vomiting, or loss of appetite If you notice [umms.org]

  Side Effects Diarrhea, nausea, vomiting, stomach upset, loss of appetite, changes in taste, and headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. [webmd.com]

• Photophobia

  Our patient experienced photophobia and marked conjunctival injection. [pediatrics.aappublications.org]

  Acute toxoplasma retinochoroiditis may cause sudden onset of visual loss and pain, sometimes associated with floaters or photophobia. [doi.org]

• Dermatitis

  Adverse Effects: GI – nausea, vomiting Hematologic – pancytopenia, agranulocytosis, macrocytic anemia, thrombocytopenia Skin – toxic erythema, erythema nodosum, fixed local eruption, erythema multiforme, Lyell’s syndrome, Exfoliative dermatitis, urticaria [antimicrobe.org]

  Sulfonamide-like skin reactions, including exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have occurred. [briandeer.com]

  Contact Dermatitis. 1996;35: 234–236. III. Romano A, Viola M, Mondino C, et al. Diagnosing nonimmediate reactions to penicillins by in vivo tests. Int Arch Allergy Immunol. 2002;129:169 –174. III. [aaaai.org]

  Use Alternative Significant - Monitor Closely All Interactions Sort By: Adverse Effects Frequency Not Defined Aseptic meningitis Fever Maculopapular rash (3-7% at 200 mg/day; incidence higher with larger daily doses) Erythema multiforme Exfoliative dermatitis [reference.medscape.com]

  Serious side effects include: Serious allergic reactions Exfoliative dermatitis Stevens-Johnson syndrome Phototoxicity Cholestatic jaundice C. Difficile diarrhea Primsol may cause anemia due to a deficiency of folic acid. [medicinenet.com]

• Photosensitivity

  Photosensitivity has been reported. Fever is not uncommon but occasionally hypersensitivity reactions may be severe and manifest as anaphylaxis. Cases of aseptic meningitis have also been reported. [briandeer.com]

  Side effects Trimethoprim is associated with its own range of potential side effects, including: Nausea, vomiting Sore mouth Taste disturbances Diarrhea Photosensitivity Skin rash Trimethoprim is also associated with more sinister effects: Hyperkalemia [pharmafactz.com]

  Photosensitivity (e.g., erythematous phototoxic eruptions with subsequent hyperpigmentation of sun-exposed skin) has been reported. 105 106 General Precautions Selection and Use of Anti-infectives To reduce development of drug-resistant bacteria and [web.archive.org]

  Some patients have photosensitivity reactions, that is, they develop skin rashes on parts of their body that are exposed to the sun. [medicinenet.com]

• Photosensitive Skin Rash

  Side effects Trimethoprim is associated with its own range of potential side effects, including: Nausea, vomiting Sore mouth Taste disturbances Diarrhea Photosensitivity Skin rash Trimethoprim is also associated with more sinister effects: Hyperkalemia [pharmafactz.com]

Appropriate workup includes the evaluation of antineutrophil cytoplasmic antibodies (ANCAs), with a positive titer raising concern for the associated primary vasculitides including microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) [ncbi.nlm.nih.gov]

• Staphylococcus Aureus

  Abstract Skin and soft tissue infection (SSTIs) due to Staphylococcus aureus, particularly community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), are common in human immunodeficiency virus (HIV)-infected populations in the United [ncbi.nlm.nih.gov]

  Research Article Structural comparison of chromosomal and exogenous dihydrofolate reductase from Staphylococcus aureus in complex with the potent inhibitor trimethoprim First published: 02 February 2009 Cited by: 29 Abstract Dihydrofolate reductase (DHFR [doi.org]

  Introduction Trimethoprim-sulfamethoxazole is an old antibiotic active against Staphylococcus aureus. [bmj.com]

Base-Line Characteristics of 81 Patients with Wegener's Granulomatosis, According to Treatment. [doi.org]

[…] alone for treatment of acute, uncomplicated cystitis; 163 however, value of trimethoprim alone for treatment of acute, uncomplicated UTIs has been questioned. b Fixed combination containing trimethoprim and sulfamethoxazole (co-trimoxazole) is used for [drugs.com]

[…] mild to moderate Pneumocystis jiroveci (formerly Pneumocystis carinii ) pneumonia † (PCP) in HIV-infected adults. 102 110 115 119 120 121 125 Should not be used alone for treatment of PCP. b Travelers’ Diarrhea Has been used for treatment and prevention [web.archive.org]

[…] line), and in the treatment of documented acute cystitis at risk of complications. [ncbi.nlm.nih.gov]

The review of clinical data indicated that a combination of SXT+fluoroquinolone was not associated with improved prognosis compared with monotherapy. [ncbi.nlm.nih.gov]

The prognosis is favourable with standard therapy for hyperkalaemia and withdrawal of trimethoprim. [bjcardio.co.uk]

[…] necrotizing vasculitis that is especially likely to involve the kidneys. 1 In untreated patients, the mean survival is only five months and the one-year mortality rate is 82 percent. 2 Treatment with cyclophosphamide and prednisolone dramatically improves the prognosis [doi.org]

In the absence of systemic findings, however, a drug etiology must also be considered. [ncbi.nlm.nih.gov]

Hydroxylation of warfarin by human cDNA-expressed cytochrome P-450: a role for P-4502C9 in the etiology of (S)-warfarin-drug interactions. Chem Res Toxicol 1992;5:54-9. Cribb AE, Spielberg SP, Griffin GP. [ebmconsult.com]

Corachan Etiology of traveller’s diarrhea in Spanish travellers to developing countries Eur J Epidemiol, 9 (1993), pp. 217-223 [5.] E. Heikkila, A. Siitonen, M. Jahkola, M. Fling, L. Sundstrom, P. [elsevier.es]

KEYWORDS: AIDS; epidemiology; methicillin – S. aureus resistant to (MRSA); skin infections [ncbi.nlm.nih.gov]

(Received May 01 2012) (Revised July 30 2012) (Accepted August 29 2012) (Online publication September 25 2012) Key words Antibiotics; birth defects; epidemiology; pregnancy Correspondence c1 Author for correspondence: Dr J. T. [web.archive.org]

ISSN: 0950-2688 EISSN: 1469-4409 URL: /core/journals/epidemiology-and-infection × [doi.org]

The pathophysiology of drug-induced aseptic meningitis is poorly understood. In the adult population, trimethoprim-sulfamethoxazole is one of the antibiotics most commonly associated with aseptic meningitis. [pediatrics.aappublications.org]

(via organic amino compound ) drug allergen Any drug which causes the onset of an allergic reaction. antibacterial drug A drug used to treat or prevent bacterial infections. [ebi.ac.uk]

Recommendations to prevent this serious interaction should be developed and implemented in the currently available therapeutic guidelines related to MTX therapy. [ncbi.nlm.nih.gov]

USPHS/IDSA Prevention of Opportunistic Infections Working Group. [doi.org]