{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:13:11Z","timestamp":1790053991774,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to characterize the risk of death in older adults co\u2010prescribed low\u2010dose methotrexate and TMP\u2010SMX <jats:italic>vs<\/jats:italic>. low\u2010dose methotrexate and a cephalosporin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective, population\u2010based, new\u2010user cohort study in Ontario, Canada (April 1, 2002\u2013August 1, 2022) using linked administrative healthcare data. Older adults taking low\u2010dose methotrexate who were newly co\u2010prescribed TMP\u2010SMX (<jats:italic>n<\/jats:italic>\u2009=\u20091602) were matched 1:1 with those who were newly co\u2010prescribed a cephalosporin. The primary outcome was death within 30\u2009days of the antibiotic dispensing date. Secondary outcomes included all\u2010cause hospitalization, a hospital visit with myelosuppression and a hospitalization with persistent infection defined as the main diagnosis. Propensity score matching was used to balance comparison groups on indicators of baseline health. Risk ratios (RR) were obtained using modified Poisson regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a propensity\u2010score matched cohort of 3204 adults taking low\u2010dose methotrexate, the 30\u2010day risk of death was similar in adults co\u2010prescribed TMP\u2010SMX <jats:italic>vs<\/jats:italic>. a cephalosporin (14\/1602 [0.87%] <jats:italic>vs<\/jats:italic>. 15\/1602 [0.94%]; RR 0.93 [95% CI 0.45\u20131.93]). The risk of all\u2010cause hospitalization (RR 1.49 [95% CI 1.13\u20131.97]) and infection (RR 2.78 [95% CI 1.30\u20135.95]) was higher in adults treated with TMP\u2010SMX than those treated with cephalosporins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In older adults taking low\u2010dose methotrexate, co\u2010prescription of TMP\u2010SMX <jats:italic>vs<\/jats:italic>. a cephalosporin was not associated with a higher 30\u2010day risk of death but was associated with a higher 30\u2010day risk of all\u2010cause hospitalization and hospital admission with persistent infection. If verified, these risks should be balanced against the benefits of co\u2010prescribing TMP\u2010SMX and low\u2010dose methotrexate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16365","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T01:09:18Z","timestamp":1733706558000},"page":"1263-1271","source":"Crossref","is-referenced-by-count":2,"title":["Co\u2010prescription of low\u2010dose methotrexate and trimethoprim\u2010sulfamethoxazole and the 30\u2010day risk of death among older adults: A cohort study"],"prefix":"10.1111","volume":"91","author":[{"given":"Hasti","family":"Sadeghi","sequence":"first","affiliation":[{"name":"Department of Biology Western University  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"},{"name":"Department of Epidemiology &amp; Biostatistics Western University  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"McArthur","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Sontrop","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics Western University  London ON Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheikh S.","family":"Abdullah","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8324-1472","authenticated-orcid":false,"given":"Brad L.","family":"Urquhart","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Western University  London Ontario Canada"},{"name":"Division of Clinical Pharmacology, Department of Medicine Western University  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-6564","authenticated-orcid":false,"given":"Flory T.","family":"Muanda","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"},{"name":"Department of Epidemiology &amp; Biostatistics Western University  London ON Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre  London Ontario Canada"},{"name":"Department of Physiology and Pharmacology Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24596"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000589"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01213011\u2010200505000\u201000002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.111.038794"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.4.1.1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules24061140"},{"key":"e_1_2_11_8_1","volume-title":"Trimethoprim sulfamethoxazole","author":"Kemnic TR","year":"2024"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/525536"},{"key":"e_1_2_11_10_1","unstructured":"Methotrexate (Product Monograph).https:\/\/www.cancercareontario.ca\/en\/drugformulary\/drugs\/monograph\/44166. 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