Co-trimoxazole-induced severe haemolysis: the experience of a large general hospital in Hong Kong.
The sulphamethoxazole component of co-trimoxazole can cause clinically significant haemolysis, particularly in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Erythrocyte G6PD deficiency is common amongst Southern Chinese in Hong Kong, affecting 4.4% of the males and 0.35% of the females. The incidence of this complication amongst the 0.9 million subjects aged > or =15 years residing in the New Territories East during a 12-month period in 1994-95 was determined. A search of the computerized medical record system in our medical unit at the Prince of Wales Hospital, the sole general hospital for the region, was used to identify such cases. Of a total of 46 patients having a diagnosis ICD code of 282 (hereditary haemolytic anaemias), 283 (acquired haemolytic anaemias) or 960 (poisoning by antibiotics), none had haemolysis due to co-trimoxazole. Based on the consumption of co-trimoxazole tablets in the Prince of Wales Hospital, it was estimated that 2163 subjects aged > or =15 years received this drug from the hospital alone. The number of subjects who were treated in the community was not known but experience in Sweden suggested that there could be 2-3 times more. Severe haemolysis due to co-trimoxazole appears to be exceedingly rare in Hong Kong as in the United States and Sweden.
Chan
T Y
TY
Department of Clinical Pharmacology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.