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Trimethoprim-sulfamethoxazole revisited
Philip A Masters1, Thomas A O'Bryan, John Zurlo
1Division of General Internal Medicine, The Pennsylvania State University College of Medicine, 500 University Dr, Suite 4100, Hershey, PA 17033, USA. pmasters@psu.edu
Archives of Internal Medicine
|February 18, 2003
Summary
Trimethoprim-sulfamethoxazole remains valuable for infections, but rising resistance necessitates careful use. It serves as a cost-effective option and retains its place for specific indications.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Practice
Background:
- Trimethoprim-sulfamethoxazole has been a cornerstone in treating common infections for over 30 years.
- Evolving antibiotic resistance and new broad-spectrum agents necessitate a re-evaluation of its clinical application.
Purpose of the Study:
- To redefine the appropriate use of trimethoprim-sulfamethoxazole in contemporary clinical practice.
- To assess its current role considering changing resistance patterns and newer antibiotic alternatives.
Main Methods:
- Review of clinical practice guidelines and resistance data.
- Analysis of trimethoprim-sulfamethoxazole's efficacy against contemporary pathogens.
- Comparative assessment with newer generation antibiotics.
Main Results:
- Increasing resistance has modified its traditional empirical therapy role.
- It remains a useful alternative to newer agents when resistance is considered.
- Demonstrates potential as a cost-effective pathogen-directed therapy, potentially preserving newer antibiotics.
Conclusions:
- Trimethoprim-sulfamethoxazole's utility persists, particularly when resistance patterns are factored into treatment decisions.
- It offers a valuable, cost-effective strategy for pathogen-directed therapy.
- Continues to be the preferred agent for several specific clinical indications.
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