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Brian Deer: Bactrim - a secret epidemic

An investigation by Brian Deer for The Sunday Times of London over
side-effects and risks from the antibiotic known as Bactrim, Septra,
Septrin, smz-tmp
, Sulfatrim, co-trimoxazole, and many other
names. Plus up-to-date emails and side-effects information


   
Toll of suffering: The first reports in the newspaper series exposed deaths and injuries in the UK, kept hidden for decades, caused by the antibiotic known most commonly as Bactrim, Septra, Septrin, Apo-Sulfatrim, SMZ-TMP and co-trimoxazole, but with many other names worldwide. The opening story appeared on page 1 of The Sunday Times of London way back in February 1994

The pill that killed: One of the first responses to Brian Deer's initial stories was an approach from the mother of 18-year-old Justine Gibbs, whose horrifying death, caused by Septrin, formed the core for the feature at this link about trimethoprim - sulfamethoxazole's potential side-effects. The Sunday Times, March 20 1994 One woman's fight: In the following year, three support groups were formed in the United Kingdom to campaign for urgent action against Bactrim - Septra - Septrin - Septran. One was run by Kate Reid, (pictured left), a secretary from East London, whose alarming experience was reported in The Sunday Times Magazine, July 9 1995 Small victory: Aware of the impending magazine report on Kate Reid (left), the British government abruptly altered the drug's official prescribing indications, as reported in the newspaper on Sunday July 9 1995. But in the rest of the world little changed. The worldwide web is today loaded with sites recommending the product
   
Suffering in secrecy: In response to stories in the newspaper, hundreds of harrowing letters and phone calls were received from people who said they believed that they or a family member was a victim of the drug's side-effects. This cross-section of only six letters has been picked, showing the range of complaints then leveled against the antibiotic. More followed in emails to this site
Current problems: Since 2002, this site has collected emails from visitors reporting experiences. You can browse these by date, following the links on each page, or search the site. To search, insert "Bactrim" and keyword(s) [eg "heart"]. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29]
Side-effects summary: A brief digest of risks and potential problems of Bactrim from PDRhealth, a consumer service of the Physician's Desk Reference. For more information, browse the links on this page, or interrogate this site with the search feature below. Remember that Bactrim DS, Septra, Septrin, Sulfatrim, SMZ-TMP, co-trimoxazole etc, are all the same drug

   
A doctor writes: Having prescribed a needlessly-dangerous pharmaceutical for most of their professional careers, many British family doctors were outraged by the challenge over Bactrim - Septrin - Septra - Septran. Many felt their patients were alarmed unfairly by Brian Deer's reports - stressing side-effects, rather than typical patients' experiences. This link includes letters from some, who frankly couldn't believe what they were reading. In due course, they changed their minds
Our clients were appalled: After Brian Deer's first Sunday Times story, way back in 1994, lawyers for Wellcome plc, manufacturer of Septrin in the UK, fired off warning letters, implying that the company was thinking of suing the newspaper and its reporter over the page 1 investigation. They also argued that the drug's broad-spectrum of therapeutic benefits outweighed possible risks. By 2005, however, prescriptions in the UK had slumped to a few thousand annually - unlike in the USA
   

Hard sell: The Bactrim - Septrin - Septra - SMZ - TMP investigation sprang from Brian Deer's inquiries into the Wellcome organization, a part-drug-company-part-charity, broken up after the campaign. Here's also a memo on founder Henry Wellcome

Wellcome's world: Septrin was the foundation upon which the Wellcome organization rose. But, as this chart from The Sunday Times reveals, a research funding money-go-round may have led regulators and experts on side-effects to give it an easy ride
Chronology of a campaign: After the first Sunday Times reports, apparent victims of the drug's side effects who contacted the paper were interviewed by Brian Deer on a standard format, and campaigning groups were founded - at arm's length. This short chronology summarises the campaign and includes links to pages with the initial questionnaire form and other early documents

   
By any other name: The British campaign focused on the dominant brands in the UK - Septrin and Bactrim. But the drug's contents - a combination of sulfamethoxazole (from Roche) and trimethoprim (from Wellcome) - is marketed worldwide in dozens of guises, further obscuring the casualties from side-effects. The tablet on the left is Sulfatrim - in the common DS 'double-strength' or 'forte' dose. A list of brands can be found at this link
A Commons touch: As the campaign gathered strength, a parliamentary debate was held in 1995, at which then-opposition Labour Party members pressed the then-Conservative government for action over the evidence of needless deaths and injuries. A minister wrongly claimed that rival antibiotics were no safer than Septrin
UK use restricted: After bitter resistance from the pharmaceutical industry and its friends among regulators, senior doctors forced changes to the product's UK data sheet, implictly acknowledging the campaign's claim that the risk-benefit profile was skewed. They said the drug should be restricted to Aids and special situations
   
   
What was your experience? The original investigation is now old, but the side-effects risks remain unchanged, and emails are received from visitors to this site all the time. If you have experience of Bactrim - Septrin - Septra - Septran - Sulfatrim -- co-trimoxazole - cotrimoxazole - SMZ-TMP - Bactrim DS etc, you feel free to let Brian Deer know about it by clicking this link

BRIAN DEER: SIDE-EFFECTS OF BACTRIM SEPTRA SEPTRIN SULFATRIM CO-TRIMOXAZOLE TRIMETH-SULFA SMZ-TMP