Patients prescribed a common antibiotic medication had a higher risk of acute respiratory failure than those prescribed comparable drugs, such as amoxicillin, according to research published Nov. 24 in JAMA.
Compared to amoxicillin and cephalosporins, trimethoprim-sulfamethoxazole presents a higher risk for acute respiratory failure. In 2019, the FDA added a warning and label change regarding this risk in healthy adolescents and young adults.
Researchers in Ontario, Canada, conducted the first population-based study confirming the FDA’s warning.
Their study utilized eight healthcare databases in the Ontario province to analyze the risk of acute respiratory failure after use of amoxicillin or trimethoprim-sulfamethoxazole. They examined the 30-day risk of a hospital visit among 10- to 25-year-olds who were dispensed one of the three antibiotics between 2003 and 2023.
Fifteen of the 44,801 patients (0.03%) who used trimethoprim-sulfamethoxazole visited a hospital within 30 days with acute respiratory failure, compared to 49 of the 530,417 patients (0.01%) who used amoxicillin. Among those who experienced acute respiratory failure, those taking trimethoprim-sulfamethoxazole visited the hospital within an average of nine days, while those in the amoxicillin cohort averaged 20 days.
“These findings supported the FDA warning, and if replicated, the risks should be carefully weighed against the benefits of TMP-SMX use,” the researchers wrote. “Regulatory agencies could reinforce the FDA warning, and product monographs and prescribing guidelines should be updated and revised accordingly.”
