We report one such case, in which life-threatening hyperkalaemia developed after institution of high-dose trimethoprim-sulfamethoxazole
(co-trimoxazole) for PJP.
coli strains were Trimethoprim-Sulfamethoxazole
(38.67%), Piperacillin - Tazobactam (34.47%) and Amoxycillin - Clavulanic Acid (32%) and (100%) resistant to Penicillin, Ceftriaxone, Ceftazidime and Cefotaxime.
The cure rate was similar in patients in the clindamycin group (83.1%) and the trimethoprim-sulfamethoxazole
group (81.7%), and the cure rate in each antibiotic group was significantly higher than that in the placebo group (68.9%; P<.001 for both comparisons).
The most frequently dispensed antibiotics during the first trimester of pregnancy were nitrofurantoin (34.7%), ciprofloxacin (10.5%), cephalexin (10.3%), and trimethoprim-sulfamethoxazole
Several drugs have been proposed for treatment including pyrimethamine, sulfadiazine, spiramycin, clindamycin, and trimethoprim-sulfamethoxazole
coli demonstrated a higher level of resistance to all of the antimicrobials except trimethoprim-sulfamethoxazole
Results: The rate of resistance to trimethoprim-sulfamethoxazole
was up to 27 (18%) and the highest resistance to quinolone family belonged to ofloxacin (20%) and the lowest rate was for gatifloxacin (16%).
Also, the use of trimethoprim-sulfamethoxazole
prophylaxis routinely in this population may potentially increase the risk of developing multidrug resistant (MDR) bacterial infections [9,10].
Sensitivities were evaluated and the bacteria was sensitive to levofloxacin, amikacin, cefepime, ceftazidime, gentamicin, meropenem, piperacillin/tazobactam, tobramycin, and trimethoprim-sulfamethoxazole
. It was found to be resistant to aztreonam, cefotaxime, and ciprofloxacin, with incubation period of 5 days.
Because the Gram-stain of her sputum on HD 8 was consistent with a possible Nocardia infection, coverage with clindamycin was discontinued, high dose trimethoprim-sulfamethoxazole
(5 mg/kg IV every 6 hours) was added to an increased dose of ceftriaxone (50 mg/kg IV every 12 hours) for appropriate coverage.
Intravenous ceftriaxone was given for 10 days followed by oral rifampicin and trimethoprim-sulfamethoxazole
. The blood brucella agglutination titer was 1:320 at the second month and long-term antibiotic treatment was planned with rifampicin and trimethoprim-sulfamethoxazole
Pilar Tornero and colleagues used patch testing and control oral challenge in patients with previous fixed drug eruptions to trimethoprim-sulfamethoxazole
or an unknown sulfonamide (Contact Dermatitis 2004;51:57-62).