{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:10:18Z","timestamp":1779361818492,"version":"3.51.4"},"reference-count":5,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Trimethoprim\u2013sulfamethoxazole (TMP\u2013SMX) is a widely used antibiotic for various infections but is often associated with hyperkalemia. In this case series, we evaluate the use of fludrocortisone (FCS), a mineralocorticoid receptor agonist, in managing TMP\u2013SMX-induced hyperkalemia. Six patients treated with TMP\u2013SMX for infectious indications developed hyperkalemia within 2\u20136 days of therapy initiation. The administration of FCS at doses ranging from 0.1 to 0.2 mg daily effectively stabilized potassium levels in all patients within 1\u20132 days, allowing most to continue the TMP\u2013SMX treatment. These findings highlight the efficacy of FCS in mitigating TMP\u2013SMX-induced potassium retention, thereby providing a safe and practical approach to maintaining essential antibiotic therapy.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0102","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:25:59Z","timestamp":1748352359000},"page":"475-477","source":"Crossref","is-referenced-by-count":3,"title":["Successful Use of Fludrocortisone for the Management of Trimethoprim\u2013Sulfamethoxazole-Induced Hyperkalemia: A Case Series"],"prefix":"10.4269","volume":"113","author":[{"given":"Roopa","family":"Acharya Basrur","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkata Swathi Kiran","family":"Pothumarthy","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjely","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muralidhar","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen Kumar","family":"Tirlangi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Pharmacotherapy","first-page":"14","article-title":"Trimethoprim: Mechanisms of action, antimicrobial activity, bacterial resistance, pharmacokinetics, adverse reactions, and therapeutic indications","volume":"1","author":"Gleckman","year":"1981"},{"key":"b2","series-title":"PLoS One","first-page":"e0248524","article-title":"Efficacy and safety of trimethoprim-sulfamethoxazole for the prevention of pneumocystis pneumonia in human immunodeficiency virus-negative immunodeficient patients: A systematic review and meta-analysis","volume":"16","author":"Li","year":"2021"},{"key":"b3","series-title":"Drug Saf","first-page":"227","article-title":"Trimethoprim-induced hyperkalaemia: Clinical data, mechanism, prevention and management","volume":"22","author":"Perazella","year":"2000"},{"key":"b4","series-title":"Ann Pharmacother","first-page":"184","article-title":"Trimethoprim\/sulfamethoxazole desensitization","volume":"30","author":"Cortese","year":"1996"},{"key":"b5","series-title":"Exp Clin Transplant Off Transplant","first-page":"69","article-title":"Fludrocortisone among adult renal transplant recipients with persistent hyperkalemia: Single-center experience","volume":"20","author":"Gheith","year":"2022"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p475.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p475.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p475.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T14:00:19Z","timestamp":1754488819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p475.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":5,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0102","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]}}}