{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T11:25:38Z","timestamp":1764674738134,"version":"3.46.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sulfamethoxazole\/trimethoprim is utilized to treat various infections, but its use can be limited by hyperkalaemia. Sodium zirconium cyclosilicate is a potassium binder, which has been shown to lower potassium in chronic kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the safety and efficacy of sodium zirconium cyclosilicate for patients experiencing sulfamethoxazole\/trimethoprim-induced hyperkalaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients receiving treatment with sulfamethoxazole\/trimethoprim and sodium zirconium cyclosilicate therapy concomitantly for at least 48\u2005h between 2021 and 2024 were identified. Efficacy was evaluated by potassium change from baseline, proportion of patients achieving normokalaemia by 24 and 48\u2005h, and time to potassium normalization. Safety was assessed by evaluating hypokalaemia occurrence while on sodium zirconium cyclosilicate therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 22 patients included. The median total daily dose of sulfamethoxazole\/trimethoprim was 960\u2005mg or 15\u2005mg\/kg\/day. Fifteen patients (68%) were treated for confirmed Stenotrophomonas maltophilia or Pneumocystis pneumonia infections. Eight patients (36%) received a loading dose of sodium zirconium cyclosilicate 10\u2005g three times daily for 48\u2005h prior to receiving 10\u2005g daily. The median difference in potassium at baseline and the end of sodium zirconium cyclosilicate therapy was 0.9\u2005mmol\/L. Fourteen patients of 22 (64%) and 19 of 21 patients (90%) achieved normokalaemia by 24 and 48\u2005h, respectively. The median time to potassium normalization was 23.5\u2005h. There were no instances of hypokalaemia while on sodium zirconium cyclosilicate therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sodium zirconium cyclosilicate was efficacious at lowering elevated potassium in patients receiving sulfamethoxazole\/trimethoprim therapy without inducing hypokalaemia. This suggests sodium zirconium cyclosilicate may be considered in patients with treatment-limiting hyperkalaemia due to sulfamethoxazole\/trimethoprim, especially when sulfamethoxazole\/trimethoprim is preferred therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf380","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T12:07:04Z","timestamp":1758888424000},"page":"3381-3385","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of sodium zirconium cyclosilicate usage for hyperkalaemia secondary to sulfamethoxazole\/trimethoprim therapy"],"prefix":"10.1093","volume":"80","author":[{"given":"Dixie","family":"Pyles","sequence":"first","affiliation":[{"name":"Department of Pharmacy, West Virginia University Medicine\u2014West Virginia University Hospitals , 1 Medical Center Drive, Morgantown, WV ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Kovacic Scherrer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West Virginia University Medicine\u2014West Virginia University Hospitals , 1 Medical Center Drive, Morgantown, WV ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0345-3403","authenticated-orcid":false,"given":"Erika","family":"Zarfoss Ponce","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West Virginia University Medicine\u2014West Virginia University Hospitals , 1 Medical Center Drive, Morgantown, WV ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda Jo","family":"Shigle","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West Virginia University Medicine\u2014West Virginia University Hospitals , 1 Medical Center Drive, Morgantown, WV ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"2025120206224369200_dkaf380-B1","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1056\/NEJMoa1411487","article-title":"Sodium zirconium cyclosilicate in hyperkalemia","volume":"372","author":"Packham","year":"2015","journal-title":"N Engl J Med"},{"key":"2025120206224369200_dkaf380-B2","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1007\/s40265-018-0991-6","article-title":"Sodium zirconium cyclosilicate: a review in hyperkalaemia","volume":"78","author":"Hoy","year":"2018","journal-title":"Drugs"},{"key":"2025120206224369200_dkaf380-B3","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1164\/rccm.2008-740ST","article-title":"An official American Thoracic Society statement: treatment of fungal infections in adult pulmonary and critical care patients","volume":"183","author":"Limper","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2025120206224369200_dkaf380-B4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1128\/CMR.00019-11","article-title":"Stenotrophomonas maltophilia: an emerging global opportunistic pathogen","volume":"25","author":"Brooke","year":"2012","journal-title":"Clin Microbiol Rev"},{"key":"2025120206224369200_dkaf380-B5","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.ijantimicag.2008.09.010","article-title":"Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence","volume":"33","author":"Avgeri","year":"2009","journal-title":"Int J Antimicrob Agents"},{"key":"2025120206224369200_dkaf380-B6","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jacc.2024.11.014","article-title":"Sodium zirconium cyclosilicate for management of hyperkalemia during spironolactone optimization in patients with heart failure","volume":"85","author":"Kosiborod","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2025120206224369200_dkaf380-B7","doi-asserted-by":"publisher","first-page":"ciae 403","DOI":"10.1093\/cid\/ciae403","article-title":"Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant gram-negative infections","author":"Tamma","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2025120206224369200_dkaf380-B8","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1056\/NEJM199305273282103","article-title":"Comparison of atovaquone (566C80) with trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS","volume":"328","author":"Hughes","year":"1993","journal-title":"N Engl J Med"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/12\/3381\/64701357\/dkaf380.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/12\/3381\/64701357\/dkaf380.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T11:22:46Z","timestamp":1764674566000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/80\/12\/3381\/8285848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":8,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,10,14]]},"published-print":{"date-parts":[[2025,12,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkaf380","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"type":"print","value":"0305-7453"},{"type":"electronic","value":"1460-2091"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,10,14]]}}}