December 1981

Hematologic Abnormalities After Oral Trimethoprim-Sulfamethoxazole Therapy in Children

Author Affiliations

From the Division of Infectious Diseases (Drs Asmar and Dajani) and the Department of Pediatrics (Drs Asmar, Maqbool, and Dajani), Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit.

Am J Dis Child. 1981;135(12):1100-1103. doi:10.1001/archpedi.1981.02130360008004

• 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 count, ≤ 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 <.001). Thrombocytopenia (platelet count, < 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 <.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.

(Am J Dis Child 1981;135:1100-1103)