Snapshot
- A 28-year-old man presents to the emergency department with worsening shortness of breath and fever. His symptoms began approximately 1 week ago. He has a medical history of HIV infection and he is non-adherent with his antiretroviral therapy. Physical examination is notable for bilateral adventitial sounds. A chest radiograph demonstrates bilateral interstitial infiltrates. His CD4 count is 180/uL. He is started on trimethoprim-sulfamethoxazole. (Pneumocystis pneumonia)
Introduction
- Mechanism of action
- Mechanism of resistance
- altered bacterial dihydropteroate synthase
- Clinical use
- gram-positive organisms
- gram-negative organisms
- Nocardia
- Adverse reaction
- hypersensitivity reactions
- hemolysis in patients with G6PD deficiency
- tubulointerstitial nephritis
- Stevens-Johnson syndrome
- photosensitivity
- infantile kernicterus
- displaces drugs that bind to albumin
- e.g., raises warfarin levels