Evidence map›Paper›PMID 40441678›Full record

SynthesisBritish journal of clinical pharmacology2025

Safety of sulfamethoxazole-trimethoprim for the treatment of bacterial infection in outpatient settings: A systematic review and meta-analysis with active comparator disproportionality analysis.

Rebecca Preyra, Lujain Ez Eddin, Fatemeh Ahmadi, Atefeh Jafari, Flory T Muanda

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rebecca PreyraDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Lujain Ez EddinDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.
Fatemeh AhmadiICES Western, London, ON, Canada.
Atefeh JafariICES Western, London, ON, Canada.
Flory T MuandaDepartment of Physiology and Pharmacology, Western University, London, Ontario, Canada.ORCID https://orcid.org/0000-0003-4682-6564

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSulfamethoxazole-trimethoprim (SMX-TMP) is a widely used antibiotic for treating bacterial infections, but its safety in adult outpatients remains understudied. This systematic review and meta-analysis evaluated the safety profile of SMX-TMP and identified critical research gaps. The pharmacovigilance study aimed to validate and extend findings from meta-analyses to better understand the real-world safety of SMX-TMP.

methodsWe searched MEDLINE and Embase up to 12 August 2024, to identify studies comparing adverse drug events (ADEs) following SMX-TMP vs. other antibiotics in adult outpatients. Meta-analyses were performed where data allowed. A pharmacovigilance study using the Food and Drug Administration Adverse Event Reporting System was conducted to supplement our findings.

resultsOur review, which included 43 studies, found SMX-TMP had a nearly 3-fold higher risk of rash compared to other antibiotics (pooled risk ratio 2.56, 95% confidence interval [1.69, 3.89], I

conclusionOur meta-analyses and pharmacovigilance study suggested SMX-TMP was associated with increased risk of ADEs compared to other antibiotics including amoxicillin/clavulanate, azithromycin and nitrofurantoin. Further robust research is essential to confirm these safety signals and guide clinical practice.

Indexed as

Anti-Bacterial AgentsBacterial InfectionsTrimethoprim, Sulfamethoxazole Drug CombinationAdverse Drug Reaction Reporting SystemsHumansOutpatientsPharmacovigilanceAnti-Bacterial AgentsTrimethoprim, Sulfamethoxazole Drug Combinationadverse drug eventcotrimoxazolecutaneous drug reactionSeptra

Identifiers

PMID40441678
PMCPMC12122145

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.