Abstract | BACKGROUND: METHODS: We conducted a population-based, nested case-control study of a cohort of elderly patients 66 years or older who were residents of Ontario, Canada, and who were receiving continuous therapy with either an ACEI or an ARB. Case patients were those with a hyperkalemia-associated hospitalization within 14 days of receiving a prescription for trimethoprim-sulfamethoxazole, amoxicillin, ciprofloxacin, norfloxacin, or nitrofurantoin. For each case, we identified up to 4 control patients from the same cohort matched for age, sex, and presence or absence of chronic renal disease and diabetes. Odds ratios were determined for the association between hyperkalemia-associated hospitalization and previous antibiotic use. RESULTS: During the 14-year study period, we identified 4148 admissions involving hyperkalemia, 371 of which occurred within 14 days of antibiotic exposure. Compared with amoxicillin, the use of trimethoprim-sulfamethoxazole was associated with a nearly 7-fold increased risk of hyperkalemia-associated hospitalization (adjusted odds ratio, 6.7; 95% confidence interval, 4.5-10.0). No such risk was found with the use of comparator antibiotics. CONCLUSIONS:
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Authors | Tony Antoniou, Tara Gomes, David N Juurlink, Mona R Loutfy, Richard H Glazier, Muhammad M Mamdani |
Journal | Archives of internal medicine
(Arch Intern Med)
Vol. 170
Issue 12
Pg. 1045-9
(Jun 28 2010)
ISSN: 1538-3679 [Electronic] United States |
PMID | 20585070
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Angiotensin II Type 1 Receptor Blockers
- Angiotensin-Converting Enzyme Inhibitors
- Drug Combinations
- Sulfamethizole
- trimethoprim sulfamethizole
- Trimethoprim
- Potassium
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Topics |
- Aged
- Aged, 80 and over
- Angiotensin II Type 1 Receptor Blockers
(therapeutic use)
- Angiotensin-Converting Enzyme Inhibitors
(therapeutic use)
- Cardiovascular Diseases
(complications, drug therapy)
- Drug Combinations
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Humans
- Hyperkalemia
(blood, chemically induced, epidemiology)
- Incidence
- Male
- Ontario
(epidemiology)
- Population Surveillance
- Potassium
(blood)
- Prognosis
- Renin-Angiotensin System
(drug effects)
- Retrospective Studies
- Risk Factors
- Sulfamethizole
(adverse effects, therapeutic use)
- Time Factors
- Trimethoprim
(adverse effects, therapeutic use)
- Urinary Tract Infections
(complications, drug therapy)
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