Trimethoprim/sulfamethoxazole-induced acute renal failure: A case report
Journal Title: Journal of Health and Social Sciences - Year 2017, Vol 2, Issue 2
Abstract
Th e patient was an 80-year-old man who arrived at the emergency room with breathing problems. He presented a history of chronic obstructive pulmonary disease (COPD), hypertension, diabetes mellitus and early (stage 1) chronic renal failure with normal levels of creatinine and no sign and symptoms of renal disease. A chest X-ray showed pneumonia. Th erefore, he was fi rst treated with 1 g daily of ceftriaxone IV. We did not observe any clinical improvement, and for this reason, a sputum culture was performed to guide the right antibiotic treatment. Subsequently, we started a new antibiotic therapy with trimethoprim/sulfamethoxazole (TMP/SMX) adjusted to renal functioning. Appropriate medical treatment was administered, as well as urine alkalinisation. After the fi rst day of treatment, the patient’s clinical and laboratory status worsened very quickly, with an increased level of serum creatinine from 1.5 to 3.5 mg/dL. We stopped administering the antibiotic therapy immediately. However, we observed acute renal failure with a serum creatinine level of 9.0 mg/dL and four days after his admission, the patient died. Literature showed that patients can develop acute kidney injury (AKI) during or immediately following TMP/SMX therapy. Intrinsic renal impairment –rather, interstitial nephritis– appeared responsible for the great majority of cases, and impairment was transient if therapy was discontinued. In our study, despite the therapy with TMP/SMX was immediately discontinued, and our patient underwent appropriate medical treatment, urine alkalinisation and, then, haemodialysis, the AKI was rapidly fatal. In conclusion, particular attention should be paid to prescribing TMP/SMX to patients aff ected by chronic renal failure.
Authors and Affiliations
Gabriella Nucera, Valentina Raffaelli, Lisa Caliari, Giulia Cantoni, Pietro Marino
Keywords
Related Articles
- EP ID EP216348
- DOI 10.19204/2017/trmt8
- Views 110
- Downloads 0
Terbinafine versus itraconazole: a long-term, randomized, double-blind, clinical trial in chronic pulmonary aspergillosis. A pilote study
Background: The frequency of pulmonary aspergillosis has been increasing for decades. Standard oral treatment is associated with tolerability problems and interactions with commonly used medications. Present data suggest...
Incidence and survival of skin melanoma in Puglia: A comparison with the rest of Italy
Introduction: There is a wide heterogeneity in incidence, prevalence, mortality and survival of skin melanoma through the world and in Italy as well. In this study we investigated, for the first time, incidence, mortalit...
Comparison of conventional versus robotic-assisted total hip arthroplasty using the Mako system: An Italian retrospective study
Introduction: Our research aimed to evaluate differences in terms of length of hospital stay and clinical outcomes between robotic-arm assisted using MAKO system and standard manual implantation in a group of patients wh...
Intracranial CT findings in traumatic brain injury: A retrospective, cross-sectional study among Igbo population in Nigeria
Introduction: Traumatic brain injury (TBI) is a major cause of death and disability and in recent years has been increasingly reported even in developing countries. Computed Tomography (CT) plays a key role in accurate T...
The key role of government national planning around the world for antimicrobial resistance: State of the art and perspectives
Antimicrobial resistance (AMR) is ‘the ability of microorganisms to grow in the presence of a chemical (drug) that would normally kill them or limit their growth’ [1]. As a result, infections persist in the body, killing...