Anaphylaxis to trimethoprim: An under‐appreciated risk in acute medical care

Abstract

Anaphylaxis is a severe, systemic allergic reaction, which is frequently unexpected and carries a high mortality risk as a medical emergency. Anaphylaxis to trimethoprim is not a well recognized event. Since trimethoprim represents the leading antibiotic for the treatment of urinary tract infections, its potential to cause anaphylaxis needs to be recognized, whether alone or as the 'active' ingredient in cotrimoxazole (trimethoprim-sulphamethoxazole combination), by those prescribing it and those providing acute care. A case of probable anaphylaxis following trimethoprim ingestion is presented with discussion supporting its potency including evidence at an immunological level highlighting its under-appreciated risk in acute medical care.

Antibiotic prophylaxis in immunosuppressed patients – Missed opportunities from trimethoprim-sulfamethoxazole allergy label

“… 30 Ironically, in the case of immediate type B (IgE-mediated) adverse reactions (eg, urticaria or anaphylaxis), trimethoprim is more often the culprit. 31 , 32 , 33 , 34 , 35 Incorrect allergy labeling of patients who have had an allergic reaction to TMP-SMX as “sulfur allergic” may result in them receiving trimethoprim which could be dangerous.…”

Kinetic adsorption of drugs using carbon nanofibers in simulated gastric and intestinal fluids

“…It is used for the treatment of various bacterial infections in combination with sulfamethoxazole (TMP/SMX) as co‐trimoxazole. However, it is necessary to recognize the potential of TMP to cause anaphylaxis which is a severe, systemic allergic reaction carrying a high mortality risk 15 …”

“…However, it is necessary to recognize the potential of TMP to cause anaphylaxis which is a severe, systemic allergic reaction carrying a high mortality risk. 15 Commercial CNF which was supplied as a greener advanced material alternative in its raw form was used as adsorbent for PM and TMP removal in SGF and SIF.…”