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Trimethoprim/sulfamethoxazole-associated pseudomembranous colitis
Drug Intelligence & Clinical Pharmacy
|March 1, 1982
Abstract:
A case of TMP/SMX-associated pseudomembranous colitis is described in a patient being treated for a urinary tract infection. Pseudomembranes are visualized on proctosigmoidoscopy, and stool cultures identified Clostridium difficile as the causative organism. The patient was treated successfully with oral vancomycin. A review of this infrequently reported adverse reaction to TMP/SMX is presented, emphasizing etiology and treatment.
Insights
A patient developed pseudomembranous colitis from trimethoprim/sulfamethoxazole (TMP/SMX) treatment for a urinary tract infection. Oral vancomycin successfully treated this rare adverse reaction caused by Clostridium difficile.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pharmacology
Background:
- Urinary tract infections (UTIs) are common and often treated with antibiotics.
- Trimethoprim/sulfamethoxazole (TMP/SMX) is a frequently prescribed antibiotic for UTIs.
- Antibiotic-associated colitis is a known, albeit infrequent, complication of antibiotic therapy.
Observation:
- A patient undergoing treatment for a UTI with TMP/SMX developed pseudomembranous colitis.
- Proctosigmoidoscopy revealed characteristic pseudomembranes.
- Stool cultures confirmed Clostridium difficile as the causative pathogen.
Findings:
- TMP/SMX can induce pseudomembranous colitis.
- Clostridium difficile is the identified organism responsible for this adverse reaction.
- The patient's condition resolved with oral vancomycin therapy.
Implications:
- This case highlights an infrequent but serious adverse reaction to TMP/SMX.
- Early recognition and appropriate treatment (e.g., vancomycin) are crucial for managing TMP/SMX-associated C. difficile colitis.
- Clinicians should consider this diagnosis in patients with diarrhea during or after TMP/SMX treatment.