New research suggests that administration of co-trimoxazole in patients aged ≥66 years receiving angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers is associated with an increased risk of sudden death compared with administration of amoxicillin. In this case-controlled study, approximately three deaths within 14 days occurred per 1,000 prescriptions of co-trimoxazole. The researchers propose that this effect might be due to undiagnosed hyperkalaemia, and alternative antibiotics that do not contain trimethoprim should be considered for these patients.
References
Fralick, M. et al. Co-trimoxazole and sudden death in patients receiving inhibitors of renin–angiotensin system: population based study. BMJ 10.1136/bmj.g6196
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Co-trimoxazole associated with increased mortality. Nat Rev Nephrol 11, 2 (2015). https://doi.org/10.1038/nrneph.2014.212
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DOI: https://doi.org/10.1038/nrneph.2014.212