Use of trimethoprim-sulfamethoxazole singly and in combination with other antibiotics in immunocompromised patients.
Experience with trimethoprim-sulfamethoxazole (TMP-SMZ) alone or in combination with other agents in the treatment of immunocompromised patients other than those with Pneumocystis carinii pneumonitis and the acquired immunodeficiency syndrome is reviewed. A comparative study involving 126 episodes of fever showed a higher rate of response to a TMP-SMZ-carbenicillin regimen than to a gentamicin-carbenicillin combination (85% vs. 69%, respectively, P less than or equal to .04). In another study TMP-SMZ was used after unsuccessful therapy with the combination of an antipseudomonal penicillin and an aminoglycoside; 54% of the 35 patients treated orally and 49% of 86 treated intravenously responded to TMP-SMZ regimens. Other studies document successful results with TMP-SMZ used in combination with either an aminoglycoside or an antipseudomonal penicillin. TMP-SMZ has a role in the treatment of infections due to gram-negative bacilli in immunocompromised hosts, particularly when the infecting agent is not Pseudomonas aeruginosa and is resistant to moxalactam but susceptible to gentamicin.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D016026:Bone Marrow Transplantation; D004311:Double-Blind Method; D004338:Drug Combinations / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007108:Immune Tolerance; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000188:drug therapy*; D011446:Prospective Studies; D011897:Random Allocation; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole