Trimethoprim-sulfamethoxazole and hypouricemia.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Trimethoprim-sulfamethoxazole and hypouricemia.

Clin Nephrol. 1996 Sep;46(3):193-8. Unique Identifier : AIDSLINE MED/97034199
Chertow GM; Seifter JL; Christiansen CL; O'Donnell WJ; Renal Division, Brigham and Women's Hospital, Boston, MA 02115, USA.

Abstract: BACKGROUND: Hypouricemia has been reported in a substantial fraction of patients with AIDS and attributed to an HIV-related renal urate transport defect. We tested the alternative hypothesis that hypouricemia was associated with the administration of high-dose trimethoprim-sulfamethoxazole TMP-SMX). METHODS: Sociodemographic, clinical, and repeated laboratory data on 45 hospitalized patients with Pneumocystis carinii pneumonia (PCP) with and without HIV infection, were abstracted by a blinded reviewer. The primary outcome of interest was the percent change in serum uric acid concentration from baseline to hospital day 5 +/- 1. RESULTS: Subjects who received TMP-SMX were older (mean age 44.8 vs. 37.0, p = 0.02), less likely to be HIV-seropositive (61% vs. 94%, p = 0.01), and more likely to have received glucocorticoid therapy (75% vs. 35%, p = 0.01) than those who received pentamidine, dapsone-trimethoprim, clindamycin-primaquine, sulfadiazine-pyramethamine, or a combination of these agents. The administration of TMP-SMX was associated with a 37% +/- 12% reduction in serum uric acid concentration, adjusting for the effects of age, sex, race, HIV antibody status, renal function, serum sodium, and the use of diuretics and glucocorticoids (p = 0.005). CONCLUSION: Among a diverse cohort of hospitalized patients with PCP, treatment with high-dose TMP-SMX was strongly associated with a reduction in serum uric acid concentration over time.

Keywords: *Anti-Infective Agents/ADVERSE EFFECTS *AIDS-Related Opportunistic Infections/DRUG THERAPY *Pneumonia, Pneumocystis carinii/DRUG THERAPY *Uric Acid/BLOOD
970430
M9741551

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