Hematologic abnormalities after oral trimethoprim-sulfamethoxazole therapy in children.
The development of hematologic abnormalities was prospectively evaluated in 50 children treated for ten days each with oral trimethoprim-sulfamethoxazole and compared with a control group of 20 children with similar infections treated with amoxicillin trihydrate. Neutropenia (polymorphonuclear neutrophilic leukocyte counts, less than or equal to 1,500/cu mm) developed in 17 (34%) of the 50 children treated with trimethoprim-sulfamethoxazole compared with one (5%) in the control group of 20 children (P less than 0.001). Thrombocytopenia (platelet count, less than 150,000/cu mm) developed in six (12%) of the children treated with trimethoprim-sulfamethoxazole, but it did not develop in any of the amoxicillin-treated children (P less than .01). Neutropenia occurred mostly during the first week of treatment and lasted a mean of 8.9 days. Thrombocytopenia was noted between the seventh and 16th day (mean, 10.3 days) and lasted a mean of 12.7 days. Both side effects resolved spontaneously without ill effects. Children treated with oral trimethoprim-sulfamethoxazole should be followed up with biweekly leukocyte and platelet counts, and treatment should be discontinued if severe neutropenia or thrombocytopenia develops.
D000658:Amoxicillin / Q000009:adverse effects; D000740:Anemia / Q000139:chemically induced; D001769:Blood / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000139:chemically induced; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000139:chemically induced; D010033:Otitis Media / Q000188:drug therapy; D013420:Sulfamethoxazole / Q000008:administration & dosage / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced; D014295:Trimethoprim / Q000008:administration & dosage / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000188:drug therapy
D000658:Amoxicillin; D014295:Trimethoprim; D013420:Sulfamethoxazole