[The frequency of adverse reactions to sulfamethoxazole with trimethoprim and risk factors in HIV patients]

Rev Alerg Mex. Apr-Jun 2020;67(2):96-101. doi: 10.29262/ram.v67i2.670.
[Article in Spanish]

Abstract

Background: Trimethoprim-sulfamethoxazole (TMP-SMZ) is the long-term use antimicrobial of choice in the prevention and treatment of opportunistic germs in patients with acquired immunodeficiency syndrome (AIDS) in whom the frequency of ADR (adverse drug reactions) is of 30% to 50 %.

Objective: To determine the adverse reactions to TMP-SMZ and their risk factors in AIDS patients.

Methods: The patients included in the study were older than 18 years of age, admitted from January 2018 to May 2019 with a confirmed diagnosis of HIV, and had had adverse drug reactions; 319 files were reviewed.

Results: A frequency of 13.16 % in adverse reactions was reported; out of 42 patients with ADR, 23 had had ADR to TMP-SMZ (54.76 %). The highest rate of adverse reactions was represented by a rash, with 56.5 %, followed by angioedema, with 21.73 %, and nettle rash, with 17.39 %. The risk factors were: infectious comorbidity (OR = 2.6) and CD4 count < 100 (OR = 6.9), without statistical significance. The dose of TMP/SMZ was a risk factor (OR = 12.7) with p = 0.017.

Conclusions: TMP-SMZ used in AIDS patients reached 54 % of the adverse drug reactions, and the dose of this medication was a risk factor.

Antecedentes: Trimetoprima-sulfametoxazol (TMP-SMZ) es el antimicrobiano de elección y de uso prolongado en la prevención y tratamiento de infecciones por gérmenes oportunistas en los pacientes con síndrome de inmunodeficiencia adquirida (sida), en quienes la frecuencia de reacciones adversas a medicamentos es de 30 a 50 %. Objetivo: Determinar las reacciones adversas a TMP-SMZ y sus factores de riesgo en pacientes con sida. Métodos: Se incluyeron pacientes mayores de 18 años con diagnóstico confirmado de infección por VIH y que presentaron reacción adversa a fármacos, de enero de 2018 a mayo de 2019. Se revisaron 319 expedientes. Resultados: Se reportó 13.16 % de reacciones adversas; de 42 pacientes con reacciones adversas a medicamentos, 23 fueron a TMP-SMZ (54.76 %). El rash representó 56.5 % de las reacciones adversas, el angioedema 21.73 % y la urticaria 17.39 %. Los factores de riesgo fueron la comorbilidad infecciosa (RM = 2.6) y la cuenta de CD4 < 100 (RM = 6.9), sin significación estadística; la dosis de TMP-SMZ fue un factor de riesgo (RM = 12.7), con p = 0.017. Conclusiones: El TMP-SMZ en los pacientes con sida ocasionó 54 % de las reacciones adversas a medicamentos y la dosis fue un factor de riesgo.

Keywords: Acquired immunodeficiency syndrome; Adverse drug reactions; Trimethoprim-sulfamethoxazole.

Publication types

  • English Abstract