Clinical characteristics of trimethoprim-sulfamethoxazole-induced rash during treatment of pertussis in children.
10.7499/j.issn.1008-8830.2504006
- Author:
Bing-Song WANG
1
;
Kai-Hu YAO
;
Xian-Yi ZHANG
1
;
Jing WU
1
;
Fei YING
;
Li-Min DONG
Author Information
1. Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children/Beijing Research Center for Respiratory Infectious Diseases/National Clinical Center for Pediatric Infectious and Allergic Disease Surveillance/National Clinical Research Center for Respiratory Diseases/Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University/National Center for Children's Health, Beijing 100045, China.
- Publication Type:Journal Article
- Keywords:
Child;
Pertussis;
Rash;
Trimethoprim-sulfamethoxazole
- MeSH:
Humans;
Male;
Child, Preschool;
Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use*;
Child;
Female;
Exanthema/chemically induced*;
Retrospective Studies;
Infant;
Whooping Cough/drug therapy*;
Adolescent
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(10):1227-1232
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To study the clinical characteristics of rashes induced by trimethoprim-sulfamethoxazole (TMP-SMZ) in children treated for pertussis and to inform safe medication practices.
METHODS:A retrospective analysis was conducted on 238 children diagnosed with pertussis and treated with TMP-SMZ at Wuhu First People's Hospital from January to August 2024. The incidence and clinical features of rashes were summarized.
RESULTS:Of 238 children, 34 (14.3%) developed rashes; 19 (55.9%) were boys, and the 5 to <10-year age group accounted for the highest proportion (70.6%, 24/34). A history of allergic disease was present in 50.0% (17/34). Rashes typically appeared on or after day 7 of therapy (82%, 28/34) and were predominantly erythematous or maculopapular eruptions (97%, 33/34); 71% (24/34) were pruritic. Fever occurred in 56% (19/34); among those who were tested for respiratory viruses, 77% (10/13) were positive for viruses such as rhinovirus and adenovirus. After discontinuation of TMP-SMZ, rashes resolved within 3 days in 97% (33/34) of patients (41% within 1 day; 56% within more than 1 but within 3 days). There was no significant difference in rash incidence between photoprotection and non-photoprotection groups (P>0.05).
CONCLUSIONS:TMP-SMZ for pertussis can induce rashes, particularly in children aged 5 to <10 years. The eruption is usually a pruritic erythematous or maculopapular rash, with over half of cases accompanied by fever and frequent concomitant viral infections. Most rashes resolve within 3 days after drug withdrawal. The potential association between the rash and sun exposure warrants further investigation.
