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'Septrin psychosis' among renal transplant patients with Pneumocystis jirovecii pneumonia

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Walker, L.E., Thomas, S., McBride, C., Howse, M., Turtle, L., Vivancos, R., Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 and Beadsworth, Mike (2011) ''Septrin psychosis' among renal transplant patients with Pneumocystis jirovecii pneumonia'. Journal of Antimicrobial Chemotherapy, Vol 66, Issue 5, pp. 1117-1119.

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Official URL: http://jac.oxfordjournals.org/content/66/5/1117.lo...

Abstract

Objectives To report on the temporal relationship between administration of trimethoprim/sulfamethoxazole to medically immunosuppressed HIV-negative renal patients with Pneumocystis jirovecii pneumonia (PCP) and the development of an acute psychosis. Methods We investigated a retrospective case series of renal transplant and immunosuppressed patients with PCP within an ongoing outbreak in the northwest of England since 2009. Four patients with PCP developed psychosis following treatment with trimethoprim/sulfamethoxazole. Results Four of twenty patients developed acute psychoses following administration of trimethoprim/sulfamethoxazole, including one accidental re-challenge. Symptoms resolved within 24 h of changing the therapy. The striking temporal relationship between the initiation and discontinuation of the drug and the behavioural changes suggests a causal relationship. Conclusions With increasing solid organ transplantation and the use of immunosuppressants, vigilance regarding trimethoprim/sulfamethoxazole dose modification is required and the routine use of therapeutic drug monitoring should be considered

Item Type:	Article
Additional Information:	PMID: 21393210
Uncontrolled Keywords:	trimethoprim/sulfamethoxazole; psychosis; adverse drug event; renal failure
Subjects:	QV Pharmacology > QV 38 Drug action. QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 920 Immunosuppression. Immunosuppressive agents
Faculty: Department:	Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI):	https://doi.org/10.1093/jac/dkr050
Related URLs:	http://www.ncbi.nlm.nih.gov/pubmed/21393...
Depositing User:	Users 43 not found.
Date Deposited:	30 Jun 2011 13:46
Last Modified:	09 Sep 2019 06:26
URI:	https://archive.lstmed.ac.uk/id/eprint/1778

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