TY - JOUR T1 - Exposure to trimethoprim–sulfamethoxazole is associated with hospitalisation for hyperkalaemia in older people treated with spironolactone JF - Evidence Based Medicine JO - Evid Based Med SP - 130 LP - 131 DO - 10.1136/ebmed-2011-100358 VL - 17 IS - 4 AU - Rebecca L Dunn Y1 - 2012/08/01 UR - http://ebm.bmj.com/content/17/4/130.abstract N2 - Commentary on: Antoniou T, Gomes T, Mamdani MM, et al. Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study. BMJ 2011;343:d5228.OpenUrlAbstract/FREE Full Text Trimethoprim–sulfamethoxazole (TMP–SMX) is a combination antibiotic used for a number of infectious diseases and organisms.1 It is generally well tolerated; however, electrolyte disturbances, primarily hyperkalaemia, have been reported with both standard and high-dose therapy.1 ,2 Spironolactone, an aldosterone receptor antagonist, predominantly used in the management of heart failure and cirrhosis, is also known to cause hyperkalaemia.3 The risk of developing hyperkalaemia during co-administration of these two commonly prescribed medications is unknown. Antoniou et al describe the association between hospitalisation for hyperkalaemia and prior use of TMP–SMX in an older population receiving spironolactone. The authors completed a population-based, nested case-control study with the objective of characterising the association between hospitalisation for hyperkalaemia and TMP–SMX use in an older population treated with spironolactone. Older subjects aged 66 years or greater, treated … ER -