Bactrim
(Trimethoprim-Sulfamethoxazole)
Index Patient, shared with permission
My Journey of Discovery
In 2018, one of my long term ECMO patients was featured in a CNN Health article as she walked and talked on ECMO. This article caught the attention of other patients and their families who felt like their stories were similar to our patient. They shared their medical histories that often lead to severe lung failure requiring ECMO (lung bypass), lung transplant, and/or death after Trimethoprim-Sulfamethoxazole (Bactrim) exposure. Since then we have found 20 patients, published multiple articles which are linked below and continue to actively evaluate new patients for this disease.
As such, there was a label change by the FDA on package inserts in 2021.
How to Collaborate
Connect with us or learn about the study below.
Our Three-Part Definition
After discussing with my friend and now co-collaborator, Dr. Jennifer Goldman, we reviewed the cases of those who reached out to us. We then published 5 pediatric cases in Pediatrics in 2019. The more we were able to share our concerns about Trimethoprim-Sulfamethoxazole (Bactrim) as a trigger for severe respiratory failure, the more requests for patient evaluations we received. In 2021, we published cases of young adults and described associated pathology in the American Journal of Respiratory and Critical Care. The pathology first reported by our colleagues (Dr. Martin Taylor, Dr. Angelia Shih and Dr. Mari Mino-Kenudson) at Massachusetts General is called Diffuse Alveolar Injury with Delayed Epithelialization. With the addition of a genomic HLA marker, we developed a three part definition including clinical, pathology and genomics for this disease process. Since this time, the FDA has changed the label for this drug to include our disease process.
If you have a question regarding this disease, please contact me.
![Steve Feldman on the default option: TMP/SMX and ARDS [2023 Winner: Most Impactful Podcast of the Year]](https://images.squarespace-cdn.com/content/v1/64242e6e9a39d5233176f923/1688325627546-R2ZSBNF9B1OKKZPVFD28/Dermasphere+-+background.png)
