Document Detail


Trimethoprim-sulfamethoxazole-associated severe hypoglycaemia: a sulfonylurea-like effect.
MedLine Citation:
PMID:  21375132     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIM: To report hypoglycaemia, a life-threatening adverse event, associated with trimethoprim-sulfamethoxazole. A sulfonylurea-like effect, leading to insulin raise, was investigated.
METHODS: Two cases of trimethoprim-sulfamethoxazole-associated hypoglycaemia in 2 patients with a diagnosis of new HIV-1-infection presenting with Pneumocystis jiroveci pneumonia are reported. The patients had no predisposing factors, such as renal or liver impairment, interfering with trimethoprim-sulfamethoxazole elimination, thus leading to hypoglycaemia. Insulin plasma levels were measured in both patients.
RESULTS: Severe hypoglycaemia was associated with increased serum levels of insulin up to 84 microU/ml (normal values < 10 microU/ml). Continuous dextrose infusion was necessary, further suggesting the sulfonylurea-like effect of sulfamethoxazole. Interestingly, plasma levels of insulin progressively raised after trimethoprim-sulfamethoxazole administration.
CONCLUSIONS: Only 18 cases of trimethoprim-sulfamethoxazole associated hypoglycaemia are reported in the literature. Hypoglycaemia is a life-threatening condition, likely underreported, to consider when trimethoprim-sulfamethoxazole administration is required, even in the absence of predisposing factors or other hypoglycaemic agents. Physician should bear in mind the potential trimethoprim-sulfamethoxazole-associated adverse event especially when prolonged treatments and elevated dosage are used.
Authors:
G Nunnari; B M Celesia; F Bellissimo; S Tosto; M La Rocca; F Giarratana; F Benanti; E Caltabiano; R Russo; B Cacopardo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European review for medical and pharmacological sciences     Volume:  14     ISSN:  1128-3602     ISO Abbreviation:  Eur Rev Med Pharmacol Sci     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-03-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9717360     Medline TA:  Eur Rev Med Pharmacol Sci     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1015-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Unit of Infectious Diseases, ARNAS Garibaldi, University of Catania, Catania, Italy. gnunnari@hotmail.com
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