Experience with trimethoprim-sulfamethoxazole in treatment of infective endocarditis.
The published experience with trimethoprim-sulfamethoxazole (TMP-SMZ) for treatment of infective endocarditis was reviewed. Among 62 cases, a high proportion had unusual causative organisms: 60% of cases were due to Coxiella burnetii or Pseudomonas species. Only 17% of patients had previously normal cardiac valves. Patients often had complicated courses in which TMP-SMZ was tried only after other treatment regimens had failed, yet a successful outcome was achieved in 61% of cases. Thirty-five patients were treated with antibiotics alone, while the other 27 patients required combined medical and surgical management. TMP-SMZ has a limited role in the management of infective endocarditis; specific guidelines for its use, including proper laboratory control, have been delineated.
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Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina 27710.
Durack
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D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004338:Drug Combinations / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D006801:Humans; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D000890:Anti-Infective Agents; D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole