ArticleThe Annals of pharmacotherapy2026
Comparative Risk of Acute Anemia and Urinary Tract Infection With Sulfamethoxazole-Trimethoprim Versus Dapsone After Kidney Transplant.
Article in The Annals of pharmacotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDapsone is an alternative prophylactic agent for opportunistic infection in kidney transplant recipients (KTRs) with sufficient glucose-6-phosphate dehydrogenase levels. Potential disadvantages include increased risk for anemia and urinary tract infection (UTI) with dapsone.
objectiveThe objective of this study was to compare the risks of anemia and UTI in KTRs who received prophylaxis for opportunistic infection after renal transplant with dapsone versus sulfamethoxazole-trimethoprim (SMX-TMP).
methodsThis single-center, retrospective, cohort review was conducted at a large academic health system. Adult patients who received SMX-TMP or dapsone prophylaxis after renal transplant were included. The primary outcome was risk of acute anemia within 90 days of transplant. Secondary outcomes included the risk of UTI post-transplant. Log-rank test was used for time-to-event analysis for the primary outcome.
resultsA total of 153 patients were included in the analysis. Patients were more likely to experience acute anemia while on dapsone compared with SMX-TMP (hazard ratio = 2.13, 95% confidence interval = 1.04-4.38, CONCLUSION AND RELEVANCE: The risk of anemia was twofold higher in KTRs who received dapsone compared with SMX-TMP but did not appear to affect the rates of erythropoiesis-stimulating agent use or blood transfusion. There was no difference in the risk of UTI. These findings may inform agent selection and monitoring of prophylaxis for opportunistic infection in KTRs.
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