Bactrim and Hyponatremia

7/08/02

Question: Can Bactrim cause hyponatremia?

<1>

Unique Identifier:9634313

Authors: David LM. Ross J.

Title: Severe hyponatraemia and severe hyperkalaemia in an HIV positive patient who received high dose co-trimoxazole.

Source: Sexually Transmitted Infections. 74(1):75-6, 1998 Feb.

<2>

Unique Identifier:7727887

Authors: Noto H. Kaneko Y. Takano T. Kurokawa K.

Institution: First Department of Internal Medicine, Faculty of Medicine, University of Tokyo.

Title: Severe hyponatremia and hyperkalemia induced by trimethoprim-sulfamethoxazole in patients with Pneumocystis carinii pneumonia.

Source: Internal Medicine. 34(2):96-9, 1995 Feb.

Abstract: An antimicrobial agent trimethoprim-sulfamethoxazole (Tmp-Smx) does not usually cause electrolyte disturbances at regular doses, and few cases of Tmp-Smx-induced electrolyte imbalance have been reported in the English-language literature to date. Recently, however, we treated two patients with Pneumocystis carinii pneumonia who developed severe hyponatremia and hyperkalemia on administration of high-dose Tmp-Smx. These electrolyte disturbances were attributable to the direct effect of Tmp-Smx on the renal distal tubules, were reversible, and corrected by infusion of a sodium-enriched and potassium-free liquid. Therefore, it is suggested that even after electrolyte disturbances have occurred, high-dose Tmp-Smx therapy may be continued for severe infectious diseases under appropriate electrolyte correction. CAS Registry/EC Number 8064-90-2 (Trimethoprim-Sulfamethoxazole Combination).

<3>

Unique Identifier:3873890

Authors: Ahn YH. Goldman JM.

Title: Trimethoprim-sulfamethoxazole and hyponatremia.

Source: Annals of Internal Medicine. 103(1):161-2, 1985 Jul.

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