Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1972 Mar 11;1(5801):651–653. doi: 10.1136/bmj.1.5801.651

Toxicity of Trimethoprim-Sulphamethoxazole in Patients with Megaloblastic Haemopoiesis

I Chanarin, J M England
PMCID: PMC1787776  PMID: 5015291

Abstract

Four consecutive patients with megaloblastic anaemia who also received therapy with trimethoprim-sulphamethoxazole all showed poor responses to specific haematinic therapy. This was attributed to trimethoprim, which suppressed reticulocyte responses in three cases and produced a pancytopenia in two and a falling haemoglobin with neutropenia in a third. A fourth patient, with pernicious anaemia, had a satisfactory reticulocyte response but experienced no clinical benefit until after withdrawal of trimethoprim.

Trimethoprim seems not to be a safe form of therapy in patients with a megaloblastic process; many of the toxic reactions reported with this drug may be on the basis of an unrecognized megaloblastic form of haemopoiesis.

Full text

PDF
651

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allison M. E., Kennedy A. C., McGeachie J., McDonald G. A. Sulphamethoxazole-trimethoprim therapy in urinary tract infection with reference to its haematological effects. Scott Med J. 1969 Oct;14(10):355–360. doi: 10.1177/003693306901401004. [DOI] [PubMed] [Google Scholar]
  2. Dawson D. W., Routledge R. C. Trimethoprim and sulphamethoxazole. Br Med J. 1971 Nov 6;4(5783):364–364. doi: 10.1136/bmj.4.5783.364-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hammett J. F. Thrombocytopenia following administration of 'Bactrim'. Med J Aust. 1970 Jul 25;2(4):200–200. [PubMed] [Google Scholar]
  4. Hughes D. T. Single-blind comparative trial of trimethoprim-sulphamethoxazole and ampicillin in the treatment of exacerbations of chronic bronchitis. Br Med J. 1969 Nov 22;4(5681):470–473. doi: 10.1136/bmj.4.5681.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hulme B., Reeves D. S. Leucopenia associated with trimethoprim-sulphamethoxazole after renal transplantation. Br Med J. 1971 Sep 11;3(5775):610–612. doi: 10.1136/bmj.3.5775.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Jenkins G. C., Hughes D. T., Hall P. C. A haematological study of patients receiving long-term treatment with trimethoprim and sulphonamide. J Clin Pathol. 1970 Jul;23(5):392–396. doi: 10.1136/jcp.23.5.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jewkes R. F., Edwards M. S., Grant B. J. Haematological changes in a patient on long-term treatment with a trimethoprim-sulphonamide combination. Postgrad Med J. 1970 Dec;46(542):723–726. doi: 10.1136/pgmj.46.542.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kahn S. B., Fein S. A., Brodsky I. Effects of trimethoprim on folate metabolism in man. Clin Pharmacol Ther. 1968 Sep-Oct;9(5):550–560. doi: 10.1002/cpt196895550. [DOI] [PubMed] [Google Scholar]
  9. McPherson V. J., Raik E. Thrombocytopenia following administration of "septrin". Med J Aust. 1970 Oct 17;2(16):754–754. doi: 10.5694/j.1326-5377.1970.tb63154.x. [DOI] [PubMed] [Google Scholar]
  10. Mohan P. Thrombocytopenia and agranulocytosis following "septrin". Practitioner. 1969 Apr;202(210):553–554. [PubMed] [Google Scholar]
  11. Paulley J. W. Drug neutropenia. Br Med J. 1970 May 9;2(5705):364–364. doi: 10.1136/bmj.2.5705.364-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Scragg J. N., Rubidge C. J. Trimethoprim and sulphamethoxazole in typhoid fever in children. Br Med J. 1971 Sep 25;3(5777):738–741. doi: 10.1136/bmj.3.5777.738. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES