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Sulfamethoxazole-Trimethoprim and Hyperkalemia in an Infant

Samantha A Hudzik1,2, Hunter C Johnson3, Joseph D Tobias1,2,3,4

  • 1Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA.

Journal of Medical Cases
|August 26, 2021
PubMed

Insights

Hyperkalemia, a serious condition of high potassium, can occur in infants. This case highlights trimethoprim-sulfamethoxazole as a potential cause in a pediatric intensive care unit (PICU) setting.

Area of Science:

  • Pediatric critical care medicine
  • Clinical pharmacology

Background:

  • Hyperkalemia is a life-threatening electrolyte imbalance with significant cardiac risks.
  • Differential diagnosis in pediatric intensive care unit (PICU) patients is broad, encompassing intake, production, excretion, and cellular shifts.
  • Acid-base status significantly influences potassium distribution.

Observation:

  • A 4-month-old infant in the PICU for respiratory failure developed hyperkalemia during recovery.
  • The infant's clinical course and laboratory values were closely monitored.

Findings:

  • The hyperkalemia was attributed to the antibiotic trimethoprim-sulfamethoxazole (Bactrim®).
  • This finding is supported by previous reports linking trimethoprim-sulfamethoxazole to hyperkalemia.

Implications:

  • Clinicians should consider trimethoprim-sulfamethoxazole as a potential cause of hyperkalemia in pediatric patients.
  • Awareness of this adverse effect is crucial for safe antibiotic prescribing in critically ill children.
  • Further investigation into drug-induced hyperkalemia mechanisms in pediatrics is warranted.

Keywords:
HyperkalemiaPotassiumTrimethoprim-sulfamethoxazole

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