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DRUG INFORMATION ROUNDS

Trimethoprim/Sulfamethoxazole for Treatment of Severe Staphylococcus aureus Infections

Director of Drug Information, Department of Pharmacy, Tufts-New England Medical Center, Boston, MA

Kenneth R Lawrence, PharmD

Infectious Disease Specialist, Department of Pharmacy, Tufts-New England Medical Center

Reprints: May Adra PharmD, Department of Pharmacy, Tufts-New England Medical Center, 750 Washington St., Boston, MA 02111-1533, fax 617/636-4567, madra{at}tufts-nemc.org

OBJECTIVE: To evaluate the role of trimethoprim/sulfamethoxazole (TMP/SMX) as an alternative to vancomycin for the treatment of severe Staphylococcus aureusinfections.

DATA SOURCES: Clinical literature was accessed through MEDLINE (1966–February 2003) and EMBASE (1980–February 2003). Key search terms included trimethoprim/sulfamethoxazole combination and Staphylococcus aureus.

DATA SYNTHESIS: An evaluation of case reports, case series, and clinical studies focusing on the use of TMP/SMX for treatment of severe S. aureusinfections was conducted. The majority of the reports indicate that TMP/SMX may be effective for the treatment of infections due to low bacterial burdens of susceptible strains of S. aureus.

CONCLUSIONS: In select infections, TMP/SMX may be a useful alternative to vancomycin for treatment of severe S. aureus infections. Additional randomized studies should be conducted comparing this agent with vancomycin and linezolid.

Key Words: Staphylococcus aureus, trimethoprim/sulfamethoxazole

Published Online, December 30, 2003. www.theannals.com, DOI 10.1345/aph.1D156

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