Bactrim - Septra - Septrin - Sulfatrim: doctors hit back on side-effects claims

Once again you have jammed the phone systems of many surgeries in the land. It is not fair to continually print a piece of sensationalist material.

As a busy rural General Practitioner, I am not happy at the implications or the conclusions that you lead people to draw from your article on "Septrin/Bactrim".

You mention the Committee on Safety of Medicines, but you fail to even mention that the number of serious adverse events reported should be considered in the light of the number of patients receiving the medicine and the benefits derived from treatment. It is important to mention that adverse events are monitored by a yellow card reporting system that to date have been very effective in alerting clinicians to adverse events of new products.

I find it intolerable that all you have succeeded in doing is scaring the majority of my patients, who may have had some of these antibiotics in the past. I am all for educating my patients but in any counselling exercise you must provide the patients with an informed benefits and risks analysis and then let the Patient decide, what course of action is best.

It is wise to remember that Health Care in Medicine is a partnership between the Doctor and the Patient and that informed choice is the way forward.

Lastly, I think that you are taking a very harsh stance against one of the many very Ethical Pharmaceutical Companies based in this country. They have a very good reputation for high standard of Research & Development of new compounds. They have made a significant contribution to the area of Patient education and continually strive to keep the Medical Profession up to date with developments and new information.

From: Dr Andrew Melhuish, Henley Health Concern, Wargrave, Berkshire

March 9 1994

Dear Sir,

I am a fifty-eight year old doctor in Henley and have read the Sunday Times for most of my life. I am in fact stopping reading it now, transferring to The Observer, and thought you would be interested in the reasons.

A small one is the size of the paper. Having said that I understand the pressures on you to produce a lot of copy - but it is off putting, particularly when Saturday's Times is also quite bulky. I know a lot of my friends have stopped getting a Sunday paper at all because it is so large.

My main reason however is the article which appeared in the 27th February edition with regards Septrin - by Brian Deer. I do feel that a well balanced paper should give two sides of an issue - otherwise worry may be produced for readers. As a GP I know a fair bit about Septrin, which we have used in the practice for very many years and which we monitor carefully. It is our second most commonly prescribed antibiotic behind Amoxicillin. In addition many of my patients come out from our local district hospital and from the major London and Oxford hospitals on this drug.

The implication of your report was that we are negligent in prescribing this drug. It maybe that this is the case but we do have, I think, a well run organisation which looks at dangerous effects from drugs run by Professor Bill Inman at Southampton and also good objective reviews of drugs through the Medical and Therapeutics Bulletin which comes out regularly. None of these have echoed the comments made in the article. Sulphonamides certainly have their problems - but they also have real advantages over other antibiotics, which will be needed if we did not use Septrin. This however is not really the case I want to make. I feel that an opinion explaining the other side of the issue should have appeared with the article. Certainly the article has worried many of my patients, particularly a 16.5 year old girl with cancer in her leg, under treatment from the Middlesex Hospital, and taking Septrin every day over quite a long period. I do feel that this has not improved the quality of what life she has remaining.