Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Trimethoprim / sulfamethoxazole

Antibiotic (sulfonamide combination)

Brand names: Bactrim, Septra

Oral health effects

  • Severe hypersensitivity (SJS/TEN) risk

    Sulfonamides are a notable cause of Stevens-Johnson syndrome/TEN with painful oral ulceration; glossitis/stomatitis also reported.

    Clinical management: Verify sulfa allergy before prescribing; treat suspected SJS/TEN as an emergency.

  • Oral candidiasis (thrush)

    Broad-spectrum antibiotics suppress commensal bacteria, allowing Candida overgrowth in the mouth.

    Mechanism: Loss of competitive inhibition from normal flora.

    Clinical management: Watch for thrush, especially with repeated courses; treat with an antifungal; reinforce hygiene.

Sources

  1. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  2. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.