What is the most appropriate next step to manage a patient experiencing hemolysis after starting trimethoprim/sulfamethoxazole?

In cases where a patient experiences hemolysis after starting trimethoprim/sulfamethoxazole, the most appropriate next step is to discontinue the medication. Trimethoprim/sulfamethoxazole can induce hemolytic anemia, particularly in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, or due to hypersensitivity reactions. Continuing the drug in the face of hemolysis would worsen the patient’s condition and could potentially lead to severe complications.

Discontinuing the offending agent is crucial in managing adverse drug reactions and allows the patient's body to begin recovery from the hemolytic process. This approach is standard practice in addressing drug-induced hemolysis and helps prevent further hemolytic activity.

While administering folic acid may have some relevance in cases of hemolytic anemia to help support blood cell production, it does not address the immediate cause of hemolysis tied to the trimethoprim/sulfamethoxazole. Starting corticosteroid therapy could be indicated for autoimmune hemolytic anemia but is not the first line of action for drug-induced hemolysis. Performing a bone marrow biopsy is a more invasive procedure primarily indicated for evaluating hematologic disorders, which is unnecessary in this situation