{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:56:14Z","timestamp":1777420574137,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T00:00:00Z","timestamp":1382659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>Background: Adverse events associated with high-dose trimethoprim-sulfamethoxazole (TMP-SMX) for outpatient infections, particularly those likely caused by community-acquired methicillin-resistant Staphylococcus aureus, have not been adequately characterized. Objective: Describe hyperkalemia and acute renal injury associated with high-dose TMP-SMX. Methods: An electronic medical record database retrospective study was conducted of outpatients receiving high-dose or low-dose TMP-SMX, comparing the incidences of hyperkalemia and acute renal injury. Results: Of 6162 patients, more developed hyperkalemia (3.06% vs 1.05%, P &lt; .0001) or acute renal injury (1.99% vs 0.700%, P = .0001) in the high-dose TMP-SMX group. Variables independently associated with hyperkalemia included age &gt;58 years (odds ratio [OR] = 3.44; 95% CI = 1.86-7.0; P &lt; .0001), concomitant receipt of an NSAID (OR = 1.71; 95% CI = 1.02-2.79; P = .044) or an ACE inhibitor (OR = 3.27; 95% CI = 2.06-5.14; P &lt; .0001), high-dose TMP-SMX prescribed (OR = 2.92; 95% CI = 1.85-4.60; P &lt; .0001), and baseline elevated serum creatinine (OR = 45.1; 95% CI = 21.7-93.2; P &lt; .0001). Variables independently associated with acute renal injury included concomitant receipt of an ACE inhibitor (OR = 2.36; 95% CI = 1.01-5.24; P = .048) or a potassium supplement (OR = 4.10; 95% CI = 1.45-10.1; P = .010), high-dose TMP-SMX prescribed (OR = 3.70; 95% CI = 1.70-8.12; P = .0012), and baseline elevated serum creatinine (OR = 2110; 95% CI = 724-7980; P &lt; .0001). Conclusions: Serum creatinine and potassium concentrations should be monitored in outpatients receiving high-dose TMP-SMX.<\/jats:p>","DOI":"10.1177\/1060028013509973","type":"journal-article","created":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T14:16:10Z","timestamp":1389017770000},"page":"1618-1626","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["An Evaluation of Hyperkalemia and Serum Creatinine Elevation Associated With Different Dosage Levels of Outpatient Trimethoprim-Sulfamethoxazole With and Without Concomitant Medications"],"prefix":"10.1177","volume":"47","author":[{"given":"Chris A.","family":"Gentry","sequence":"first","affiliation":[{"name":"Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,10,25]]},"reference":[{"key":"bibr1-1060028013509973","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01011-12"},{"key":"bibr2-1060028013509973","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir034"},{"key":"bibr3-1060028013509973","unstructured":"Bactrim\u00ae [package insert]. 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