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Terminal hepatic failure following a small dose of sulfamethoxazole-trimethoprim

D F Ransohoff, G Jacobs

    Gastroenterology
    |April 1, 1981
    PubMed

    Insights

    Sulfamethoxazole-trimethoprim can cause fatal liver damage, even at low doses. A patient died from liver failure after taking just two tablets, highlighting the risks of rechallenging susceptible individuals.

    Area of Science:

    • Pharmacology
    • Hepatology
    • Toxicology

    Background:

    • Sulfamethoxazole and sulfamethoxazole-trimethoprim are associated with severe hepatotoxicity.
    • Previous exposure may increase susceptibility to adverse drug reactions.

    Purpose of the Study:

    • To report a fatal case of hepatotoxicity following a low-dose rechallenge with sulfamethoxazole-trimethoprim.
    • To emphasize the potential danger of even small doses in susceptible patients.

    Main Methods:

    • Case report detailing a patient's history and outcome.
    • Review of previous exposure and subsequent drug ingestion.

    Main Results:

    • A patient with prior exposure to sulfamethoxazole-trimethoprim developed fatal liver failure.
    • Death occurred after ingestion of only two tablets (160 mg trimethoprim and 800 mg sulfamethoxazole).

    Conclusions:

    • Fatal hepatotoxicity can occur with low-dose rechallenge of sulfamethoxazole-trimethoprim in susceptible individuals.
    • Clinicians should exercise extreme caution when considering re-administration of this drug combination.

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