Background: Trimethoprim has been recently implicated in the development of hyperkalemia when administered at standard doses to immunocompetent patients. However, many clinicians are unaware of this potentially dangerous adverse effect. Objective: To review reported cases of trimethoprim-induced hyperkalemia in immunocompetent patients and identify predisposing factors, treatment, and outcome. Methods: A MEDLINE literature search was performed using the key words ‘trimethoprim’ and ‘hyperkalemia’. All English-language case reports and bibliographies of immunocompetent patients with trimethoprim-induced hyperkalemia were reviewed. Results: Nine cases were identified. The mean patient age was 77.6 years, and the mean duration of therapy was 10.2 days. Seven patients received standard oral dosages of trimethoprim-sulfamethoxazole for common infections, and 2 patients were concurrently receiving angiotensin-converting enzyme inhibitors. The mean pretreatment levels of creatinine and potassium were 1.01 mg/dl and 4.55 mmol/l, respectively. The mean peak serum potassium level was 7.0 mmol/l. No deaths attributable to hyperkalemia occurred. Conclusions: Hyperkalemia due to trimethoprim typically affects elderly patients administered standard oral dosages, even in the presence of a normal serum creatinine level. Concurrent angiotensin-converting enzyme inhibitor therapy may increase the risk of hyperkalemia. The prognosis is favorable with standard therapy for hyperkalemia and withdrawal of trimethoprim.
Received: Received: August 25, 1998
Accepted: October 19, 1998
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 2, Number of References : 21
Gerontology (International Journal of Experimental and Clinical Gerontoloy)
Founded 1957 by F. Verzàr as ‘Gerontologia’, merged 1975 with ‘Gerontologia Clinica’, founded 1959 by E. Woodford-Williams and A.N. Exton-Smith
Organ of the International Association of Gerontology (IAG)
Vol. 45, No. 4, Year 1999 (Cover Date: July-August 1999)
Journal Editor: W. Meier-Ruge, Basel
ISSN: 0304–324X (print), 1423–0003 (Online)
For additional information: http://www.karger.com/journals/ger
Article / Publication Details
Published online: 7/1/1999
Issue release date: July–August 1999
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 2
ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)
For additional information: http://www.karger.com/GER
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