The Risks of Using Trimethoprim/Sulfamethoxazole in Patients with Renal and Cardiac Compromise.

The purpose of this article is to familiarize physicians with the risks of prescribing trimethoprim/sulfamethoxazole (TMP/SMX) for patients who have kidney or cardiac pathology, have hyperkalemia, or take other interacting medications. Although TMP/SMX is a drug that is frequently used to treat skin and soft-tissue infections of the leg and foot, particularly if methicillin-resistant Staphylococcus aureus is identified, it is not an innocuous antibiotic. Literature documenting the many adverse effects of TMP/SMX is reviewed.

Peripheral vascular considerations.

Arterial pathology of the lower extremity is common in the elderly. It has been the author's experience that most arterial pathology affecting the foot is caused by peripheral arterial occlusive disease, emboli, or infection. One of the most important factors determining whether healing will take place is the adequacy of the arterial blood supply.