{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:28:35Z","timestamp":1788607715051,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T00:00:00Z","timestamp":1392595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Following a pneumocystis pneumonia (<jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content>) outbreak in our nephrology unit, all transplant patients were offered chemoprophylaxis with trimethoprim\u2013sulphamethoxazole (<jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content>) as the first line agent. A high rate of complications was noted. We aimed to quantify <jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content> associated adverse events and evaluate its prophylactic benefit in their light. Potential risk factors for complications' development were also investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was an observational study of outcomes in transplant recipients commenced on <jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content> prophylaxis for 1year period. End\u2010points were adverse events due to <jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content>, the additional medical burden resulting from these events, and <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content> diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>290 patients commenced on <jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content>. 110 (38%) developed complications with most common being rise in serum creatinine (<jats:styled-content style=\"fixed-case\">Cr<\/jats:styled-content>) (<jats:italic>n<\/jats:italic>\u2009=\u200963, 22%) followed by gastrointestinal symptoms (<jats:italic>n<\/jats:italic>\u2009=\u200915, 5%), and leucopenia (<jats:italic>n<\/jats:italic>\u2009=\u20095, 2%). <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content> incidence fell from 19 cases in 19 months to 2 cases in 12 months. Baseline renal function (<jats:italic>P<\/jats:italic>\u2009=\u20090.019) was an independent predictors for developing rise in <jats:styled-content style=\"fixed-case\">Cr<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">TMP\u2010SMX<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Use of chemoprophylaxis is an effective strategy in dealing with a <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content> outbreak but can lead to a high number of complications. Rises in serum <jats:styled-content style=\"fixed-case\">Cr<\/jats:styled-content> can cause significant concern and increase in the number of investigations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12201","type":"journal-article","created":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T08:34:43Z","timestamp":1388997283000},"page":"157-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Complications and outcomes of trimethoprim\u2013sulphamethoxazole as chemoprophylaxis for pneumocystis pneumonia in renal transplant recipients"],"prefix":"10.1111","volume":"19","author":[{"given":"Nicos","family":"Mitsides","sequence":"first","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Greenan","sequence":"additional","affiliation":[{"name":"School of Medicine University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Green","sequence":"additional","affiliation":[{"name":"Institute of Population Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Middleton","sequence":"additional","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Lamerton","sequence":"additional","affiliation":[{"name":"Pharmacy Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Allen","sequence":"additional","affiliation":[{"name":"Pharmacy Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Redshaw","sequence":"additional","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R","family":"Chadwick","sequence":"additional","affiliation":[{"name":"Microbiology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinari PK","family":"Subudhi","sequence":"additional","affiliation":[{"name":"Microbiology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grahame","family":"Wood","sequence":"additional","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4065\/71.1.5"},{"key":"e_1_2_6_3_1","first-page":"47","article-title":"Treatment of pneumocystis carinii with trimethoprim\u2010sulfamethoxazole","volume":"112","author":"Hughes WT","year":"1975","journal-title":"Can. Med. Assoc. J."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/513198"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.10.027"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2009.00447.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02834.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90337-D"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500030207"},{"issue":"3","key":"e_1_2_6_10_1","first-page":"CD005590","article-title":"Prophylaxis for pneumocystis pneumonia (PCP) in non\u2010HIV immunocompromised patients","author":"Green H","year":"2007","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01079.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328074"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/00042560-200008010-00007","article-title":"Reduced toxicity with gradual initiation of trimethoprim\u2010sulfamethoxazole as primary prophylaxis for Pneumocystis carinii pneumonia: AIDS clinical trials group 268","volume":"24","author":"Para MF","year":"2000","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1755-8794-5-32"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200212000-00008"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.1992.tb01760.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1981.tb01293.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05037-11"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199812150-00009"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02475.x"},{"key":"e_1_2_6_21_1","first-page":"11","article-title":"A prospective, randomized, double\u2010blind study of trimethoprim\u2013sulfamethoxazole for prophylaxis of infection in renal transplantation. Side effects of trimethoprim\u2013sulfamethoxazole, interaction with cyclosporine","volume":"119","author":"Maki DG","year":"1992","journal-title":"J. Lab. Clin. Med."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(00)88640-0"},{"key":"e_1_2_6_23_1","first-page":"9","article-title":"Adverse reactions to sulphonamide and sulphonamide\u2010trimethoprim antimicrobials: Clinical syndromes and pathogenesis","volume":"15","author":"Cribb AE","year":"1996","journal-title":"Adverse Drug. Reac. Toxicol. Rev."},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328911"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)90251-1"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)62509-9"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2010.285"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.212"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)67149-0"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12201","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T13:32:28Z","timestamp":1696167148000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,17]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1111\/nep.12201"],"URL":"https:\/\/doi.org\/10.1111\/nep.12201","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,17]]},"assertion":[{"value":"2013-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}