{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:19:47Z","timestamp":1777418387144,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1998,2,1]],"date-time":"1998-02-01T00:00:00Z","timestamp":886291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To describe a retrospective study of six HIV-positive individuals with compensated metabolic acidosis while receiving intravenous trimethoprim\/sulfamethoxazole (TMP\/SMX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>Six HIV-infected patients were treated for Pneumocystis carinii pneumonia (PCP) with high-dose intravenous TMP\/SMX. In spite of a favorable clinical and radiologic course, all six patients developed compensated metabolic acidosis 3\u20135 days after the start of treatment. This potential complication of TMP\/SMX use was successfully managed with conservative treatment (cessation of therapy with or without additional administration of intravenous bicarbonate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>TMP\/SMX is first-line therapy for PCP in HIV-positive individuals, despite a high frequency of toxic effects in these patients. In addition to the cases reported here, only two other reports of metabolic acidosis secondary to TMP\/SMX use in HIV-infected patients have been published in the literature. The precise mechanism of this untoward effect is not fully understood, although renal tubular acidosis induced by TMP\/SMX could be implicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>TMP\/SMX toxicity should be considered in the differential diagnosis of HIV-infected patients with acute metabolic acidosis. Metabolic acidosis can be expected to resolve shortly after discontinuation of the drug.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Describir una serie retrospectiva de seis pacientes infectados por VIH-positivos que desarrollaron acidosis metab\u00f3lica durante la administraci\u00f3n de trimetoprima\/sulfametoxazol (TMP\/SMX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASO:<\/jats:title>\n                    <jats:p>Seis pacientes con infecci\u00f3n por VIH y neumon\u00eda por Pneumocystis carinii (NPC) recibieron altas dosis de TMP\/SMX v\u00eda intravenosa. A pesar de un curso cl\u00ednico-radiol\u00f3gico favorable, se objetiv\u00f3 acidosis metab\u00f3lica compensada en los seis enfermos entre los 3\u20135 d\u00edas posteriores al inicio del tratamiento. Esta potencial complicaci\u00f3n del TMP\/SMX fue manejada satisfactoriamente con medidas conservadoras (suspensi\u00f3n del f\u00e1rmaco, con o sin la administraci\u00f3n adicional de bicarbonato intravenoso).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSI\u00d3N:<\/jats:title>\n                    <jats:p>TMP\/SMX es el tratamiento de elecci\u00f3n para la NPC en individuos VIH-positivos, a pesar de la elevada frecuencia de efectos adversos en estos enfermos. Adem\u00e1s de los casos comunicados aqu\u00ed, \u00fanicamente se han publicado otros dos trabajos en la literatura mundial relativos a la acidosis metab\u00f3lica como potencial efecto indeseable del TMP\/SMX en pacientes VIH-positivos. El mecanismo exacto de este efecto adverso no est\u00e1 totalmente aclarado, aunque una acidosis renal tubular inducida por el TMP\/SMX pudiera estar implicada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>Sugerimos que se incluya la posible toxicidad del TMP\/SMX en el diagn\u00f3stico diferencial de la acidosis metab\u00f3lica aguda en pacientes VIH-positivos. Si se detectara acidosis metab\u00f3lica aguda previsiblemente relacionada con TMP\/SMX, la suspensi\u00f3n del f\u00e1rmaco determinar\u00eda una r\u00e1pida normalizaci\u00f3n del equilibrio \u00e1cido-base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>D\u00e9crire une s\u00e9rie r\u00e9trospective de six individus s\u00e9ropositifs pour le VIH qui ont d\u00e9velopp\u00e9 une acidose m\u00e9tabolique compens\u00e9e alors qu'ils recevaient du trim\u00e9thoprim\/sulfam\u00e9thoxazole (TMP\/SMX) par voie intraveineuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DU CAS:<\/jats:title>\n                    <jats:p>Six patients infect\u00e9s par le VIH ont \u00e9t\u00e9 trait\u00e9s pour une pneumonie \u00e0 Pneumocystis carinii (PPC) avec des doses \u00e9lev\u00e9es de TMP\/SMX. Malgr\u00e9 une \u00e9volution clinique et radiologique favorable, les six patients ont d\u00e9velopp\u00e9 une acidose m\u00e9tabolique compens\u00e9e 3\u20135 jours apr\u00e8s le d\u00e9but du traitement. Cette complication potentiellement associ\u00e9e \u00e0 l'utilisation du TMP\/SMX a \u00e9t\u00e9 corrig\u00e9e avec succ\u00e8s \u00e0 l'aide d'un traitement conservateur (l'arr\u00eat du traitement avec l'ajout ou non de bicarbonate par voie intraveineuse).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Le TMP\/SMX demeure la th\u00e9rapie de premi\u00e8re intention chez les patients infect\u00e9s par le VIH et souffrant de PPC, malgr\u00e9 une fr\u00e9quence \u00e9lev\u00e9e d'effets toxiques chez ces patients. En plus des cas signal\u00e9s dans cet article, seuls deux autres cas d'acidose m\u00e9tabolique associ\u00e9e \u00e0 l'utilisation du TMP\/SMX ont \u00e9t\u00e9 publi\u00e9s dans la documentation scientifique. Le m\u00e9canisme pr\u00e9cis de cet effet ind\u00e9sirable n'est pas enti\u00e8rement compris, bien qu'on pense qu'une acidose tubulaire r\u00e9nale induite par le TMP\/SMX puisse \u00eatre en cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Les auteurs sugg\u00e8rent qu'une toxicit\u00e9 associ\u00e9e au TMP\/SMX devrait \u00eatre consid\u00e9r\u00e9e lors du diagnostic diff\u00e9rentiel chez les patients infect\u00e9s par le VIH qui pr\u00e9sentent une acidose m\u00e9tabolique aigue. Quand une acidose m\u00e9tabolique se d\u00e9veloppe, on peut s'attendre \u00e0 sa correction peu de temps apr\u00e8s l'arr\u00eat du m\u00e9dicament.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17042","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"185-189","source":"Crossref","is-referenced-by-count":16,"title":["Trimethoprim\/Sulfamethoxazole and Metabolic Acidosis in HIV-Infected Patients"],"prefix":"10.1177","volume":"32","author":[{"given":"Miguel C","family":"Porras","sequence":"first","affiliation":[{"name":"Miguel C Porras MD, Attending Physician, Section of Internal Medicine, Hospital of Laredo, Laredo, Cantabria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 N","family":"Lecumberri","sequence":"additional","affiliation":[{"name":"Jos\u00e9 N Lecumberri MD, Attending Physician, Section of Internal Medicine, Hospital of Laredo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis P","family":"Castrill\u00f3n","sequence":"additional","affiliation":[{"name":"Jos\u00e9 Luis P Castrill\u00f3n MD, Section Chief, Section of Internal Medicine, Hospital of Laredo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1998,2,1]]},"reference":[{"key":"bibr1-aph.17042","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-100-4-495"},{"key":"bibr2-aph.17042","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420210028004"},{"key":"bibr3-aph.17042","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199303113281006"},{"key":"bibr4-aph.17042","first-page":"238","volume":"50","author":"Kaufman A","year":"1983","journal-title":"Mt Sinai J Med"},{"key":"bibr5-aph.17042","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/4.2.426"},{"key":"bibr6-aph.17042","first-page":"685","volume":"96","author":"Ferrer A","year":"1991","journal-title":"Med Clin (Barc)"},{"key":"bibr7-aph.17042","first-page":"281","volume":"190","author":"Romeu J","year":"1992","journal-title":"Rev Clin Esp"},{"key":"bibr8-aph.17042","doi-asserted-by":"publisher","DOI":"10.1542\/peds.89.6.1072"},{"key":"bibr9-aph.17042","first-page":"49","volume":"10","author":"Murphy JL","year":"1990","journal-title":"Child Nephrol Urol"},{"key":"bibr10-aph.17042","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199302000-00023"},{"key":"bibr11-aph.17042","first-page":"596","volume":"14","author":"Flourie B","year":"1990","journal-title":"Gastroenterol Clin Biol"},{"key":"bibr12-aph.17042","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-11-199506010-00005"},{"key":"bibr13-aph.17042","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90171-9"},{"key":"bibr14-aph.17042","first-page":"291","volume-title":"Primer on the metabolic bone diseases and disorders of mineral metabolism","author":"Chesney RW","year":"1993","edition":"2"},{"key":"bibr15-aph.17042","first-page":"87","volume-title":"Current nephrology","author":"Roth KS","year":"1985"},{"key":"bibr16-aph.17042","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.141.1.30"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17042","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:07:00Z","timestamp":1777374420000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.17042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,2]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1998,2]]}},"alternative-id":["10.1345\/aph.17042"],"URL":"https:\/\/doi.org\/10.1345\/aph.17042","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,2]]}}}