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Renal tubular acidosis associated with trimethoprim-sulfamethoxazole poisoning / Acidosis tubular renal asociada a intoxicación por trimetoprim-sulfametoxazol
Perdomo-Quintero, Daniela; Gómez-Barrios, Camilo Ernesto; Zamora-Suárez, Adriana; Cifuentes-González, Juan Camilo.
  • Perdomo-Quintero, Daniela; Universidad Surcolombiana. Neiva. CO
  • Gómez-Barrios, Camilo Ernesto; Universidad Surcolombiana. Neiva. CO
  • Zamora-Suárez, Adriana; Universidad Surcolombiana. Neiva. CO
  • Cifuentes-González, Juan Camilo; Universidad Surcolombiana. Neiva. CO
Acta méd. colomb ; 45(4): 1-4, Oct.-Dec. 2020. tab
Article in English | LILACS, COLNAL | ID: biblio-1278144
ABSTRACT
Abstract The combination of trimethoprim-sulfamethoxazole (TMP-SMZ or cotrimoxazole) has a bactericidal effect on gram-positive cocci and gram-negative bacilli. It is used clinically for skin and soft tissue, respiratory and urinary tract infections, and is also relevant for prophylaxis and treatment of opportunistic infections in immunosuppressed patients. Its use at established doses in immunocompetent patients is safe, with a low rate of adverse events. However, in immunosuppressed individuals (human immunodeficiency virus [HIV], transplants, or steroid users), the adverse effects (AEs) of this medication reach 83%; and, when administered parenterally at high doses, lactic acidosis has been documented secondary to the polyethylene glycol vehicle. We present two cases of patients who ingested an overdose of TMP-SMZ and developed type 2 renal tubular acidosis (RTA), which has not been described with this medication, and whose hyperlactatemia is not explained by the polyethylene glycol excipient, as it was taken orally.
RESUMEN
Resumen La combinación de trimetoprim-sulfametoxazol (TMP-SMZ o cotrimoxazol) tiene efecto bactericida sobre cocos gram positivos y bacilos gram negativos, con uso clínico en infecciones de piel y tejidos blandos, del tracto respiratorio y urinario, además con relevancia en la profilaxis y tratamiento de infecciones oportunistas en pacientes inmunosupresos. Su uso en pacientes inmunocompetentes a dosis establecidas es seguro, con una baja tasa de eventos adversos. Sin embargo, en población con inmunosupresión virus de inmunodeficiencia humana (VIH), trasplante, o usuarios de esteroides; los efectos adversos (EA) por este medicamento alcanzan 83% y por administración parenteral en dosis elevadas se ha documentado acidosis láctica secundaria al vehículo polietilenglicol. Presentamos dos casos de pacientes que ingirieron TMP-SMZ en sobredosis, desarrollando acidosis tubular renal (ATR) tipo 2, la cual no se ha descrito en este medicamento y cuya hiperlactatemia no es explicable por el excipiente polietilenglicol debido a que el consumo fue oral.
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Full text: Available Index: LILACS (Americas) Main subject: Acidosis, Renal Tubular Type of study: Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Acta méd. colomb Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Colombia Institution/Affiliation country: Universidad Surcolombiana/CO

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Full text: Available Index: LILACS (Americas) Main subject: Acidosis, Renal Tubular Type of study: Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Acta méd. colomb Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Colombia Institution/Affiliation country: Universidad Surcolombiana/CO