From the Guidelines
Bacterium itself is not contraindicated in G6PD deficiency, but certain antibiotics used to treat bacterial infections can be harmful to G6PD-deficient patients. G6PD (glucose-6-phosphate dehydrogenase) deficiency is a genetic disorder that primarily affects how the body responds to certain medications, foods, and infections, not bacteria themselves. However, certain antibiotics used to treat bacterial infections are contraindicated in G6PD deficiency. Specifically, sulfonamide antibiotics like sulfamethoxazole (part of co-trimoxazole/Bactrim) should be avoided or used with caution in G6PD-deficient patients as they can trigger hemolytic anemia. Other antibiotics that may pose risks include nitrofurantoin, quinolones (like ciprofloxacin), and chloramphenicol. When treating bacterial infections in G6PD-deficient patients, safer antibiotic options include penicillins, cephalosporins, macrolides, and tetracyclines. The reason these medications cause problems is that G6PD deficiency reduces the body's ability to protect red blood cells from oxidative stress, which certain drugs can induce, leading to the destruction of red blood cells and potentially dangerous hemolytic anemia. According to the guidelines for the management of persons infected with HIV, screening for G6PD deficiency is recommended upon entry into care or before starting therapy with an oxidant drug in patients with a predisposing racial or ethnic background 1. Key points to consider when treating G6PD-deficient patients include:
- Avoiding certain antibiotics that can trigger hemolytic anemia
- Using safer antibiotic options
- Screening for G6PD deficiency before starting therapy with oxidant drugs.
From the FDA Drug Label
Hemolysis and Heinz body formation may be exaggerated in individuals with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, or methemoglobin reductase deficiency, or hemoglobin M. Drugs or chemicals which have produced significant hemolysis in G6PD or methemoglobin reductase deficient patients include Dapsone, sulfanilamide, nitrite, aniline, phenylhydrazine, napthalene, niridazole, nitro-furantoin and 8-amino-antimalarials such as primaquine.
The bacterium is not directly mentioned in the context of the question, but G6PD deficiency is associated with an increased risk of hemolysis when using certain drugs, including sulfonamides and dapsone.
- Key points:
- G6PD deficiency increases the risk of hemolysis with certain drugs.
- Sulfonamides and dapsone are examples of such drugs.
- No direct information about bacterium is provided in the context of G6PD deficiency. 2
From the Research
Bacterium and G6PD Deficiency
- There is no direct evidence to suggest that bacterium is contraindicated in G6PD deficiency 3, 4, 5, 6, 7.
- However, certain infections can trigger hemolytic anemia in G6PD-deficient patients 3, 5, 6.
- The evidence suggests that G6PD-deficient patients are susceptible to hemolysis due to various triggers, including infections, certain medications, and fava beans 3, 4, 5, 6.
- Some studies have identified specific medications that should be avoided in G6PD-deficient patients, but bacterium is not mentioned as a contraindication 4, 5.
Medications and G6PD Deficiency
- Certain medications, such as dapsone, methylthioninium chloride, nitrofurantoin, phenazopyridine, primaquine, rasburicase, and tolonium chloride, are known to cause hemolysis in G6PD-deficient patients 4.
- However, many other medications have been safely prescribed to G6PD-deficient patients without causing hemolysis 3, 4.
- The evidence highlights the need for evidence-based guidelines for medication use in G6PD-deficient patients to avoid unnecessary restrictions and ensure safe treatment 4, 7.