Hematologic abnormalities after oral trimethoprim-sulfamethoxazole therapy in children
B. I. Asmar, S. Maqbool and A. S. Dajani
The development of hematologic abnormalities was prospectively evaluated in
50 children treated for ten days each with oral
trimethoprim-sulfamethoxazole and compared with a control group of 20
children with similar infections treated with amoxicillin trihydrate.
Neutropenia (polymorphonuclear neutrophilic leukocyte counts, less than or
equal to 1,500/cu mm) developed in 17 (34%) of the 50 children treated with
trimethoprim-sulfamethoxazole compared with one (5%) in the control group
of 20 children (P less than 0.001). Thrombocytopenia (platelet count, less
than 150,000/cu mm) developed in six (12%) of the children treated with
trimethoprim-sulfamethoxazole, but it did not develop in any of the
amoxicillin-treated children (P less than .01). Neutropenia occurred mostly
during the first week of treatment and lasted a mean of 8.9 days.
Thrombocytopenia was noted between the seventh and 16th day (mean, 10.3
days) and lasted a mean of 12.7 days. Both side effects resolved
spontaneously without ill effects. Children treated with oral
trimethoprim-sulfamethoxazole should be followed up with biweekly leukocyte
and platelet counts, and treatment should be discontinued if severe
neutropenia or thrombocytopenia develops.
