This site is intended for health professionals only

At the heart of general practice since 1960

Antibiotics 'increase hyperkalaemia risk' in diuretic patients

Prescribing antibiotics to older patients receiving spironolactone is associated with a major increase in the risk of admission to hospital for hyperkalaemia, a BMJ study shows.

A case-control study of a population on elderly patients aged 66 or older in Ontario, Canada, shows those receiving chronic treatment with spironolactone had a 12-fold-increased risk of being admitted to hospital with hyperkalaemia within 14 days of a prescription.

During the 18-year study period, 6,900 admissions for hyperkalaemia were identified, 306 of which occurred within 14 days of a prescription of co-trimoxazole, amoxicillin, norfloxacin or nitrofuranoin. After matching cases to controls 10.8% of spironolactone users received at least one prescription for trimethoprim-sulfamethoxazole.

Compared with amoxicillin, prescription of co-trimoxazolewas associated with a ‘marked' increase in the risk of admission to hospital for hyperkalaemia, with an adjusted odds ratio of 12.4.

Dr David Juurlink, clinical epidemiologist at the Sunnybrook Research Institute in Toronto, concluded: ‘This drug combination should be avoided when possible.'

BMJ 2011, online 12 September

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say