Use of trimethoprim-sulfamethoxazole for treatment of infections due to nocardia

Richard J. Wallace, Edward J. Septimus, Temple W. Williams, Richard H. Conklin, Terry K. Satterwhite, Margaret B. Bushby, Donna C. Hollowell

Research output: Contribution to journalArticlepeer-review

Abstract

Trimethoprim-sulfamethoxazole (TMP-SMZ) was used for treatment of 34 patients with pulmonary or cutaneous nocardiosis. Of nine patients with primary cutaneous disease, eight had rapid resolution of their infection after short-term therapy and none have relapsed after a follow-up of more than six months. The 25 patients with pulmonary nocardiosis had a good clinical response, but three of five (60%) who completed less than three months of therapy relapsed within four weeks. Of the 10 patients who completed four to six months of therapy, only one (10%) relapsed and this relapse was due to drug resistance. By the method of serial dilution in agar, 95010 of 59 isolates of Nocardia had MICs of SMZ of < 25 I-μg/ml. Fewer than 20% were susceptible to 2.5 μg of TMP/ml. Synergy between TMP and SMZ was usually present with ratios of TMP to SMZ of 1:5,1:1, or 5:1, but was less common at a ratio of 1:20. Disk susceptibility testing was easy to perform and readily separated sensitive from resistant strains. TMP-SMZ is highly effective for the treatment of nocardiosis, but the question of whether it is more effective clinically than a sulfonamide alone remains unanswered.

Original languageEnglish (US)
Pages (from-to)315-325
Number of pages11
JournalReviews of Infectious Diseases
Volume4
Issue number2
DOIs
StatePublished - Mar 1982

ASJC Scopus subject areas

  • Microbiology (medical)

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