Co-trimoxazole-induced hepatic injury--an analysis of cases with hypersensitivity-like reactions

Infection. 1987:15 Suppl 5:S259-64. doi: 10.1007/BF01643200.


Trimethoprim-sulfamethoxazole (co-trimoxazole) is used extensively for treatment of pulmonary and urinary tract infections. Side effects may affect skin, blood, bone marrow, kidney and the liver. Although a number of sulfonamides have been reported to have produced hepatic lesions, hepatitis following therapy with trimethoprim-sulfamethoxazole is a rather rare event. While trimethoprim has not yet been reported as a cause of hepatic disorders, sulfamethoxazole has occasionally been described as inducing hepatic injury. In some cases, these reactions are accompanied by symptoms indicative for allergic reactions such as fever, rash and eosinophilia. Seven well documented cases are analyzed and discussed with respect to the nature of side effects caused by co-trimoxazole.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents / adverse effects*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Drug Combinations / adverse effects
  • Drug Hypersensitivity / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sulfamethoxazole / adverse effects*
  • Trimethoprim / adverse effects*
  • Trimethoprim, Sulfamethoxazole Drug Combination


  • Anti-Infective Agents
  • Drug Combinations
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole