Treatment of Nocardia asteroides infection with trimethoprim-sulfamethoxazole.
Although sulfonamide therapy has reduced the case fatality rate in infection due to Nocardia asteroides from nearly 100% to 25% to 45% there remains a need for a still more effective chemotherapeutic regimen. We describe three cases of serious infection due to N asteroides treated successfully with trimethoprim-sulfamethoxazole (TMP-SMX) and review an additional 15 cases from the world literature. Trimethoprim and sulfamethoxazole exhibit a synergistic interaction in vitro against N asteroides, and the agent reaches antibacterial concentrations in blood, lung, and the central nervous system. Clinical results have been satisfactory in the limited number of patients treated to date.
D000368:Aged; D001847:Bone Diseases / Q000188:drug therapy; D004338:Drug Combinations; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000188:drug therapy* / Q000378:metabolism; D009616:Nocardia asteroides; D013420:Sulfamethoxazole / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D014295:Trimethoprim / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*
D004338:Drug Combinations; D014295:Trimethoprim; D013420:Sulfamethoxazole