{"title":"Successful Use of Fludrocortisone for the Management of Trimethoprim-Sulfamethoxazole-Induced Hyperkalemia: A Case Series.","authors":"Roopa Acharya Basrur, Nitin Gupta, Venkata Swathi Kiran Pothumarthy, Anjely Sebastian, Muralidhar Varma, Praveen Kumar Tirlangi","doi":"10.4269/ajtmh.25-0102","DOIUrl":null,"url":null,"abstract":"<p><p>Trimethoprim-sulfamethoxazole (TMP-SMX) is a widely used antibiotic for various infections but is often associated with hyperkalemia. In this case series, we evaluate the use of fludrocortisone (FCS), a mineralocorticoid receptor agonist, in managing TMP-SMX-induced hyperkalemia. Six patients treated with TMP-SMX for infectious indications developed hyperkalemia within 2-6 days of therapy initiation. The administration of FCS at doses ranging from 0.1 to 0.2 mg daily effectively stabilized potassium levels in all patients within 1-2 days, allowing most to continue the TMP-SMX treatment. These findings highlight the efficacy of FCS in mitigating TMP-SMX-induced potassium retention, thereby providing a safe and practical approach to maintaining essential antibiotic therapy.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Tropical Medicine and Hygiene","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4269/ajtmh.25-0102","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Trimethoprim-sulfamethoxazole (TMP-SMX) is a widely used antibiotic for various infections but is often associated with hyperkalemia. In this case series, we evaluate the use of fludrocortisone (FCS), a mineralocorticoid receptor agonist, in managing TMP-SMX-induced hyperkalemia. Six patients treated with TMP-SMX for infectious indications developed hyperkalemia within 2-6 days of therapy initiation. The administration of FCS at doses ranging from 0.1 to 0.2 mg daily effectively stabilized potassium levels in all patients within 1-2 days, allowing most to continue the TMP-SMX treatment. These findings highlight the efficacy of FCS in mitigating TMP-SMX-induced potassium retention, thereby providing a safe and practical approach to maintaining essential antibiotic therapy.
期刊介绍：
The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine.
The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development.
The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal.
Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries
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