Doctors are sounding the alarm over a widely used antibiotic taken by millions of people and linked to a number of deaths and extreme reactions.
Trimethoprim-Sulfamethoxazole, or brand name Bactrim, is used by about 3 million Americans and is most commonly used to treat mild respiratory infections, bacteria, and acne.
Emmie Bellucci, 12, from Texas, was prescribed two courses of antibiotics last year for cystic acne – a severe form that causes painful lumps deep in the skin.
A severe reaction caused her lungs to become severely injured and shut down.
She has been in hospital for five months and relies on a tube in her windpipe – a trachestomy – to help her breathe.
Doctors believe the drug may trigger an immune reaction in young patients like Emmie that damages the lining of the lungs and causes breathing problems.
Experts investigating the rare complication are now calling for more research into Bactrim's long-term harm and for tests to identify risk factors before the drug is described.
Dr. Jennifer Goldman, a pediatric infectious disease specialist at Children's Mercy Kansas City, said, “These are good drugs, and this is a very rare condition, but it's not widely known, and it should be.
'There is a chance to prevent serious complications.'
Emmie Bellucci (pictured here), a 12-year-old from Texas, developed breathing problems shortly after taking a second course of the antibiotic Bactrim for cystic acne
Emmie has been in the hospital for five months to recover from the almost fatal complication. “We thought we lost her,” her father, Frank Bellucci, told CNN
Emmie told CNN: “All I know is that it's a miracle that I'm here.”
Doctors began investigating Bactrim's serious side effects in 2018 when 16-year-old Zei Uwadia mysteriously fell ill and suffered lung failure.
After Zei's story broke, doctors at Children's Mercy Kansas City, where the teen was being treated, began receiving reports of other teen patients experiencing similar symptoms.
All of them, including Zei, had taken Bactrim.
Said died in 2019 at the age of 17, two weeks after returning home from the hospital.
Dr. Goldman and Dr. Jenna Miller of Children's Mercy Kansas City published a report in 2021 describing 14 children and young adults who they said suffered from severe acute respiratory distress syndrome (ARDS), which occurs when fluid builds up in the lungs after taking Bactrim.
The condition, which affects 200,000 Americans annually, makes it difficult for the lungs to send oxygen to the bloodstream, leading to organ failure.
One in three patients in the report died and 20 percent required a lung transplant.
The review prompted the FDA to add a warning label to Bactrim stating “serious pulmonary adverse reactions.”
Although the number of prescriptions has declined slightly in the years since, experts say doctors and patients need to be more aware of potential serious risks like these before giving the drug.
Bactrim, also called trimethoprim-sulfamethoxazole, is prescribed to about 3 million Americans for mild infections, acne, and drug-resistant bacteria
Said Uwadia, pictured here, from Kansas made headlines in 2018 when she mysteriously became ill and had breathing problems after taking Bactrim. She died in 2019 at the age of 17, just two weeks after coming home from the hospital
It is unclear when Emmie will be able to return home, although she has gained greater mobility and had her breathing support removed, according to her family's Facebook updates
Dr. Miller and Dr. Goldman's research found that all patients in their study with this severe reaction had the same type of genomic human leukocyte antigen (HLA) marker, a type of protein found on most of their cells.
These markers help the immune system determine which cells belong in the body and which are foreign.
In these patients, a specific HLA marker may have caused an immune response called diffuse alveolar injury with delayed epithelialization, causing the immune system to attack the alveoli, the air sacs in the lining of the lungs.
This leads to inflammation, fluid build-up in the lungs and lung failure.
It is unclear whether Emmie has this genetic marker.
Dr. Goldman told CNN that an estimated “20 to 30 percent of us walking around have that genetic marker, so while we know this is a first step needed to develop this response, we need to better understand other genetic risks.”
The team is working on additional research into genetic risk factors and hopes to develop tests to help doctors identify these risks before prescribing Bactrim.
Emmie said: 'They can change a lot of lives just by doing research.'
The Bellucci family is raising money for medical expenses through GoFundMe.
It's unclear when Emmie will finally be able to return home, although her family has documented her progress on Facebook, showing her trachestomy removed and her walking around the hospital.
