On 2015 Jan 05, NephJC - Nephrology Journal Club commented:

This study was discussed on Dec 2nd 2014 in the open online nephrology journal club, #NephJC, on twitter (along with a related article: the HARMONIZE trial).

Introductory comments, written by Eoin O'Sullivan, are available at the NephJC website and cross-posted at the Renal Fellow Network blog.

The discussion was quite detailed, with more than 50 participants, including nephrologists,emergency medicine physicians, fellows and residents, with great insight provided by the senior author, David Juurlink.

A transcript and a curated (i.e. Storified) version of the tweetchat are available from the NephJC website.

The highlights of the tweetchat were:

• The authors have leveraged administrative datasets to undertake numerous drug-interaction studies in the real world setting with important clinical outcomes.

• The study reports a robust association between use of co-trimoxazole and sudden death amongst elderly patients already using a renin-angiotensin system blocker. While this remains an association, and causation is elusive in observational studies such as these, the consensus was that this is quite likely to be a true effect given the physiological basis, and prior work from this group reporting greater hospitalization for hyperkalemia from the same combination.

• The final takeaway message was to be careful and prescribe co-trimoxazole specifically, and indeed all antibiotics generally, only when truly necessary.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at NephJC.com.

On 2015 Jan 05, NephJC - Nephrology Journal Club commented:

This study was discussed on Dec 2nd 2014 in the open online nephrology journal club, #NephJC, on twitter (along with a related article: the HARMONIZE trial).

Introductory comments, written by Eoin O'Sullivan, are available at the NephJC website and cross-posted at the Renal Fellow Network blog.

The discussion was quite detailed, with more than 50 participants, including nephrologists,emergency medicine physicians, fellows and residents, with great insight provided by the senior author, David Juurlink.

A transcript and a curated (i.e. Storified) version of the tweetchat are available from the NephJC website.

The highlights of the tweetchat were:

• The authors have leveraged administrative datasets to undertake numerous drug-interaction studies in the real world setting with important clinical outcomes.

• The study reports a robust association between use of co-trimoxazole and sudden death amongst elderly patients already using a renin-angiotensin system blocker. While this remains an association, and causation is elusive in observational studies such as these, the consensus was that this is quite likely to be a true effect given the physiological basis, and prior work from this group reporting greater hospitalization for hyperkalemia from the same combination.

• The final takeaway message was to be careful and prescribe co-trimoxazole specifically, and indeed all antibiotics generally, only when truly necessary.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC, or visit the webpage at NephJC.com.