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Rhabdomyolysis Following Trimethoprim-Sulfamethoxazole Therapy: A Case Report and Review of the Literature

Mahjoubi Yasmine Salem1, Zgolli Fatma2, Dahmani Israa2

  • 1Department of Collection and Analysis of Adverse Reactions, Faculty of Medicine of Tunis, National Center Chalbi Belkahia of Pharmacovigilance, University of Tunis El Manar, Tunis, Tunisia.

Current Drug Safety
|January 31, 2025
PubMed
Abstract

Insights

Trimethoprim-Sulfamethoxazole (TMP-SMX) can cause rhabdomyolysis (RM), a rare muscle-damaging condition. This case highlights TMP-SMX-induced RM in an immunocompetent patient, emphasizing the need for clinical awareness and prompt drug withdrawal for recovery.

Area of Science:

  • Pharmacology
  • Toxicology
  • Infectious Diseases

Background:

  • Trimethoprim-Sulfamethoxazole (TMP-SMX) is a widely prescribed antibiotic for various infections.
  • Rhabdomyolysis (RM) is a rare adverse effect, with few documented cases, primarily in immunocompromised individuals.
  • This report focuses on TMP-SMX-induced RM in an immunocompetent patient.

Purpose of the Study:

  • To report a rare case of TMP-SMX-induced rhabdomyolysis in an immunocompetent individual.
  • To contribute to the limited literature on this specific drug-adverse event association.
  • To underscore the importance of recognizing this potential side effect across all patient populations.

Main Methods:

  • A case presentation of a 53-year-old male with septic arthritis treated with TMP-SMX.
  • Monitoring of clinical symptoms (muscle pain, weakness) and laboratory markers (Creatine Kinase levels).
  • Observation of patient recovery following TMP-SMX discontinuation.

Main Results:

  • The patient developed symptoms and elevated Creatine Kinase levels indicative of rhabdomyolysis shortly after initiating TMP-SMX.
  • Discontinuation of TMP-SMX led to a gradual decrease in Creatine Kinase levels and resolution of symptoms.
  • This represents the sixth reported instance of TMP-SMX-associated rhabdomyolysis in an immunocompetent patient.

Conclusions:

  • Clinicians should consider rhabdomyolysis as a potential adverse effect of TMP-SMX, irrespective of the patient's immune status.
  • Early recognition and prompt cessation of TMP-SMX are crucial for successful patient outcomes.
  • This case adds valuable data to the understanding of TMP-SMX-induced rhabdomyolysis.
Keywords:
Adverse drug reactionanti-bacterial agentsmyalgiarenal failurerhabdomyolysissulfamethoxazoletrimethoprim combination

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