Bactrim & elevated creatinine - Renal Fellow Network
It is too late now to call, so I am writing to ask what information is available regarding this question or does anyone know? Isn't there a more sensible antibiotic to take for cellulitis or to treat this type of infection, it has to be sulfur based? I thank those who answer, in advance.
July 16, at pm Trimethoprim, Triamterene, Amiloride, and Pentamidine have the same effect over ENaC, and therefore can cause hyperkalemia Anonymous March 24, at am I'm a practicing nephrologist. Just saw a patient 2 days ago, stage 4 CKD, Cr 2. Podiatrist placed on Bactrim. We need to educate them. Joel Topf December 21, at pm When I was a fellow, I was a subject in a couple of research studies where the subjects took cimetidine while collecting a hour urine in order to allow the urinary creatinine to better reflect glomerular filtration i.
Will be checking in on a regular basis. December 9, at pm Very interesting, thanks for your comments. Is This an Emergency? If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Often the culprit is a prescription drug. In many instances, the same drugs that are used to treat kidney disease also cause elevated creatinine. For these reasons, it is important to define the adverse effects of this drug combination on renal function. Methods Patients The Michael E. MEDVAMC has fully automated electronic medical records that document every encounter between a patient and the healthcare system.
Patients who received less than a 6 day course of treatment, those who did not have serum creatinine and blood urea nitrogen BUN determinations both within 7 days before starting and within 3 days after completing therapy, patients on haemodialysis and patients who began their antibiotic course as an outpatient were excluded.
Literature search Using Medline and Google Scholar, we searched existing English-language literature from inception, including post-marketing studies, for references to renal insufficiency, renal failure, acute kidney injury, azotemia or acute tubular necrosis and trimethoprim or sulfamethoxazole singly or together.
Data recorded Demographic data that were recorded included age, race, gender, the presence and control of diabetes mellitus and hypertension, the presence of chronic kidney disease, and HIV infection.
Bactrim Side Effects: Common, Severe, Long Term - killearnontheweb.co.uk
Previous source to penicillin may not be obvious. Patients may also experience swelling of the face, lips and tongue and may develop trouble breathing or swallowing as a result of the airway swelling. If you've had an allergic reaction to one type of bactrim, you may be — dose are injection necessarily — allergic to other types of penicillin or injection some cephalosporins. Common medications that may interact with Bactrim include: anticonvulsants such as phenytoin antidepressants, such as amitriptyline, amoxapine, dose desipramine cyclosporine anticoagulants blood thinnerssuch as warfarin blood pressure medications, such as captopril or enalapril indomethacin medications that affect the nervous system, such bactrim amantadine or memantine methotrexate.
Penicillins and bactrim drugs Penicillins belong to a class of antibacterial drugs called affect antibiotics. Take only as directed by your doctor and do does share with anyone else as kidneys can encourage the development of drug-resistant bacteria how reduce the effectiveness of Bactrim.
Previous exposure to penicillin may not be obvious.
Call or emergency medical help if you experience signs of a severe reaction or suspected anaphylaxis after taking penicillin. Request an Appointment at Mayo Clinic Causes Penicillin allergy occurs when your immune system becomes hypersensitive to the drug — mistakenly reacting to the drug as a harmful substance, as if it were a viral or bacterial infection.
Before the immune system can become sensitive to penicillin, you have to be exposed to the medication at least once. If and when your immune system misidentifies penicillin as a harmful substance, it develops an antibody to the drug. The next time you take the drug, these specific antibodies flag it and direct immune system attacks on the substance. Chemicals released by this activity cause the signs and symptoms associated with an allergic reaction.
Previous exposure to penicillin may not be obvious. Some evidence suggests that trace amounts of it in the food supply may be sufficient for a person's immune system to create an antibody to it. Penicillins and related drugs Penicillins belong to a class of antibacterial drugs called beta-lactam antibiotics. How it works Bactrim is a brand trade name for a fixed combination medicine containing two antibiotics - sulfamethoxazole and trimethoprim.
Sulfamethoxazole stops bacteria from making dihydrofolic acid and trimethoprim prevents the formation of tetrahydrofolic acid; both significant steps in the formation of nucleic acids and proteins essential to many bacteria.
Bactrim belongs to the class of medicines known as antibiotics. The sulfamethoxazole component belongs to the class of medicines known as sulfonamides, and the trimethoprim component belongs to the class of medicines known as folic acid inhibitors. Upsides Bactrim is a combination antibiotic used to treat infections such as those affecting the ear, urinary tract, lungs, or gastrointestinal tract.
Active against a wide range of susceptible strains of gram-positive and gram-negative bacteria, such as Streptococcus pneumoniae, Escherichia coli, Klebsiella species, Enterobacter species, Haemophilus influenzae, and others. Effective concentrations of both sulfamethoxazole and trimethoprim are reached in the gastrointestinal tract, urinary tract, lungs, mouth, middle ear, and vagina.
Both antibiotics also cross the placenta and are excreted in human milk. Bacterial resistance is less likely to develop with Bactrim than if either ingredient sulfamethoxazole or trimethoprim is taken alone.
Downsides If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Nausea, vomiting, abdominal pain, diarrhea, mouth or tongue inflammation, weight loss, flatulence, rash, and itchy skin.
May not be suitable for some people including those with kidney or liver disease, folate deficiency the elderly, chronic alcoholics, people taking anticonvulsants are at risk of folate deficiency , glucosephosphate deficiency, porphyria, severe allergies, thyroid dysfunction, or bronchial asthma.
Not suitable for pregnant or breastfeeding women or in infants less than two months of age. Elderly people may be more susceptible to the side effects of Bactrim.
Rarely, severe, sometimes fatal reactions have been reported following the administration of sulfonamide-containing medicines such as Bactrim.
Reactions have included Stevens-Johnson syndrome a disorder involving the skin and mucous membranes , liver disease, and blood disorders such as thrombocytopenia low platelets. Bactrim should be discontinued at the first sign of a skin rash or any other worrying side effect. May lower blood sugar levels in people without diabetes. May interact with a number of other drugs including thiazides, warfarin, phenytoin, leucovorin, methotrexate, digoxin, and medications for diabetes.
Note: In general, seniors or children, people with certain medical conditions such as liver or kidney problems, heart disease, diabetes, seizures or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects 4.
Sulfamethoxazole/Trimethoprim Injection Dosage & Rx Info | Uses, Side Effects
- BACTRIM Dosage & Rx Info | Uses, Side Effects
- Sulfamethoxazole And Trimethoprim (Oral Route) Description and Brand Names - Mayo Clinic
- Bactrim Dosage Guide - killearnontheweb.co.uk
- Bactrim (Sulfamethoxazole and Trimethoprim Oral/Injection)
- Indications for BACTRIM:
Bactrim Dosage
This is not a complete list of does effects and others may occur. No interference occurs, however, if methotrexate is measured by a radioimmunoassay RIA.
Use how dosing syringe provided, or use bactrim medicine affect device not a kidneys spoon.
Allergy not use two doses at one time. They do not treat viral infections e. Infusion Reactions Local https://killearnontheweb.co.uk/wp-content/ngg/modules/photocrati-show/valium-10mg-or-robaxin.html and inflammation due to extravascular infiltration of the infusion have been observed with bactrim and trimethoprim. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Penicillin patients for hematologic toxicity. These effects are reversible by folinic acid therapy.
Stability of trimethoprim-sulfamethoxazole injection in five infusion fluids
There were no abnormalities in the 10 children whose mothers received the drug during the first trimester. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.
Disorders of potassium dose. Discontinue sulfamethoxazole and trimethoprim if a significant reduction in the count bactrim any formed blood element injection noted.
Clostridium Difficile Associated Diarrhea Clostridium injection associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including sulfamethoxazole and trimethoprim, and may range in severity from mild diarrhea to fatal colitis. Sulfite sensitivity is seen bactrim frequently in asthmatic than in non-asthmatic people. No interference occurs, however, dose methotrexate is measured by a radioimmunoassay RIA.
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Although appropriate culture and susceptibility studies should be performed, therapy may be started while awaiting the results of these studies. Sulfamethoxazole and trimethoprim are also contraindicated in pregnant patients and nursing mothers, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus. Sulfamethoxazole and trimethoprim are contraindicated in pediatric patients less than 2 months of age.
Clinical signs, such as rash, sore throat, fever, arthralgia, pallor, purpura, or jaundice may be early indications of serious reactions. Cough, shortness of breath, and pulmonary infiltrates are hypersensitivity reactions of the respiratory tract that have been reported in association with sulfonamide treatment. Thrombocytopenia Sulfamethoxazole and trimethoprim-induced thrombocytopenia may be an immune-mediated disorder. Severe cases of thrombocytopenia that are fatal or life threatening have been reported.
Thrombocytopenia usually resolves within a week upon discontinuation of sulfamethoxazole and trimethoprim. Streptococcal Infections and Rheumatic Fever The sulfonamides should not be used for the treatment of group A beta-hemolytic streptococcal infections. In an established infection, they will not eradicate the streptococcus and, therefore, will not prevent sequelae such as rheumatic fever. Clostridium Difficile Associated Diarrhea Clostridium difficile associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including sulfamethoxazole and trimethoprim, and may range in severity from mild diarrhea to fatal colitis.
Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. Hypertoxin producing strains of C. CDAD must be considered in all patients who present with diarrhea following antibiotic use.
Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. Sulfite Sensitivity Sulfamethoxazole and trimethoprim injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people.
The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
Benzyl Alcohol Contains benzyl alcohol. In newborn infants, benzyl alcohol has been associated with an increased incidence of neurological and other complications which are sometimes fatal. Adjunctive Treatment With Leucovorin for Pneumocystis Jiroveci Pneumonia Treatment failure and excess mortality were observed when trimethoprim and sulfamethoxazole was used concomitantly with leucovorin for the treatment of HIV positive patients with Pneumocystis jiroveci pneumonia in a randomized placebo controlled trial.
General Folate Deficiency Sulfamethoxazole and trimethoprim injection should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency e. Hematological changes indicative of folic acid deficiency may occur in elderly patients or in patients with preexisting folic acid deficiency or kidney failure. These effects are reversible by folinic acid therapy. Hemolysis In glucosephosphate dehydrogenase deficient individuals, hemolysis may occur.
Infusion Reactions Local irritation and inflammation due to extravascular infiltration of the infusion have been observed with sulfamethoxazole and trimethoprim. Megaloblastic anemia due to folate deficiency. Marked hepatic damage. Severe renal insufficiency when renal status cannot be monitored.
Avoid prolonged administration. Monitor CBCs, urine, and renal function. Hepatic or renal dysfunction. Sulfonamides can also displace methotrexate from plasma protein binding sites and can compete with the renal transport of methotrexate, thus increasing free methotrexate concentrations. There have been reports of marked but reversible nephrotoxicity with coadministration of Bactrim and cyclosporine in renal transplant recipients.
Increased digoxin blood levels can occur with concomitant Bactrim therapy, especially in elderly patients. Serum digoxin levels should be monitored. Increased sulfamethoxazole blood levels may occur in patients who are also receiving indomethacin.
Occasional reports suggest that patients receiving pyrimethamine as malaria prophylaxis in doses exceeding 25 mg weekly may develop megaloblastic anemia if Bactrim is prescribed. The efficacy of tricyclic antidepressants can decrease when coadministered with Bactrim. Bactrim potentiates the effect of oral hypoglycemics that are metabolized by CYP2C8 e. Additional monitoring of blood glucose may be warranted. Cases of interactions with other OCT2 substrates, memantine and metformin, have also been reported.
No interference occurs, however, if methotrexate is measured by a radioimmunoassay RIA. Mutagenesis: In vitro reverse mutation bacterial tests according to the standard protocol have not been performed with sulfamethoxazole and trimethoprim in combination. Observations of leukocytes obtained from patients treated with sulfamethoxazole and trimethoprim revealed no chromosomal abnormalities.
Sulfamethoxazole alone was positive in an in vitro reverse mutation bacterial assay and in in vitro micronucleus assays using cultured human lymphocytes. Trimethoprim alone was negative in in vitro reverse mutation bacterial assays and in in vitro chromosomal aberration assays with Chinese Hamster ovary or lung cells with or without S9 activation. In in vitro Comet, micronucleus and chromosomal damage assays using cultured human lymphocytes, trimethoprim was positive.
In mice following oral administration of trimethoprim, no DNA damage in Comet assays of liver, kidney, lung, spleen, or bone marrow was recorded. Pregnancy: While there are no large, well-controlled studies on the use of sulfamethoxazole and trimethoprim in pregnant women, Brumfitt and Pursell,8 in a retrospective study, reported the outcome of pregnancies during which the mother received either placebo or sulfamethoxazole and trimethoprim.
The incidence of congenital abnormalities was 4. There were no abnormalities in the 10 children whose mothers received the drug during the first trimester.
In a separate survey, Brumfitt and Pursell also found no congenital abnormalities in 35 children whose mothers had received oral sulfamethoxazole and trimethoprim at the time of conception or shortly thereafter. Because sulfamethoxazole and trimethoprim may interfere with folic acid metabolism, Bactrim should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
These studies, however, were limited by the small number of exposed cases and the lack of adjustment for multiple statistical comparisons and confounders. These studies are further limited by recall, selection, and information biases, and by limited generalizability of their findings. Lastly, outcome measures varied between studies, limiting cross-study comparisons.
These doses are approximately 5 and 6 times the recommended human total daily dose on a body surface area basis. In some rabbit studies, an overall increase in fetal loss dead and resorbed conceptuses was associated with doses of trimethoprim 6 times the human therapeutic dose based on body surface area. Caution should be exercised when Bactrim is administered to a nursing woman, especially when breastfeeding, jaundiced, ill, stressed, or premature infants because of the potential risk of bilirubin displacement and kernicterus.
Geriatric Use: Clinical studies of Bactrim did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. There may be an increased risk of severe adverse reactions in elderly patients, particularly when complicating conditions exist, e.
In those concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. Hematological changes indicative of folic acid deficiency may occur in elderly patients. The trimethoprim component of Bactrim may cause hyperkalemia when administered to patients with underlying disorders of potassium metabolism, with renal insufficiency or when given concomitantly with drugs known to induce hyperkalemia, such as angiotensin converting enzyme inhibitors.
Discontinuation of Bactrim treatment is recommended to help lower potassium serum levels. Bactrim Tablets contain 1. Bactrim DS Tablets contain 3. Pharmacokinetics parameters for sulfamethoxazole were similar for geriatric subjects and younger adult subjects.