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December 1981

Hematologic Abnormalities After Oral Trimethoprim-Sulfamethoxazole Therapy in Children

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)