title: Trimethoprim, creatinine and creatinine-based equations.
abstract: Co-trimoxazole is a frequently prescribed antibiotic worldwide. It is composed of both trimethoprim and sulfamethoxazol (Sfx) and is used in the treatment and prophylaxis of urinary tract and Pneumocystis jirovecii infections. The Sfx component appears to be nephrotoxic at high doses or doses inappropriately adjusted for glomerular filtration rate (GFR). The trimethoprim component, even at recommended doses, inhibits tubular creatinine secretion, leading to a rapid but ultimately reversible increase in serum creatinine independent of any changes in GFR. This translates into a falsely low estimated GFR when creatinine-based equations are used. This review focuses on evidence of the differential effects of trimethoprim and Sfx on serum creatinine concentrations and GFR and their relevance to clinical practice, with particular attention to kidney transplantation.
authors.affiliation: Department of Nephrology, Dialysis, Hypertension, Transplantation, University of Liège, Liège, Belgium. pierre_delanaye@yahoo.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Delanaye
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariat
authors.forename: Etienne
authors.initials: E
authors.lastname: Cavalier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Maillard
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Krzesinski
authors.forename: Christine A
authors.initials: CA
authors.lastname: White
mesh_terms: D000892:Anti-Infective Agents, Urinary / Q000494:pharmacology*; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D016030:Kidney Transplantation; D016720:Pneumocystis Infections / Q000188:drug therapy* / Q000503:physiopathology; D045363:Pneumocystis carinii; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003404:Creatinine