[A case of Nocardia farcinica pneumonia treated with sulfamethoxazole-trimethoprim monitoring its serum concentration].
A 75-year-old male suffered from interstitial pneumonia in December 2000 and treated with predonisolone. The treatment was effective, and the dosage of predonisolone had been gradually tapered. In January 2001, when the dosage was 30 mg/day, he complained of cough and yellowish sputum. The chest X-ray and CT revealed bilateral infiltrations with cavities. He was treated with cefozopram and fluconazole. However, there were no improvements. The sputa of the 2nd, 3rd, 6th and 8th hospital days showed the presence of gram-positive branched rods, which were identified as Nocardia farcinica. Therefore, the treatment was changed to sulfamethoxazole-trimethoprim. During the treatment, serum concentration of sulfamethoxazole was repeatedly measured, and kept over 60 microgram/ml. He was swiftly recovered after the start of sulfamethoxazole-trimethoprim. This case was supposed to be the seventh one of N. farcinica pneumonia in Japan, and the measurement of the concentration of sulfamethoxazole was useful to determine its dosage.
Kachi
Shusei
S
First Department of Internal Medicine, Kyorin University of Medicine, Tokyo, Japan.
Takeda
Hideki
H
Igarashi
Hisashi
H
Tashimo
Yuko
Y
Sekine
Hideaki
H
Ochi
Masaru
M
Nakazato
Yoshinori
Y
Watanabe
Hidehiro
H
Kawai
Shin
S
Gotou
Hajime
H
Kobayashi
Hiroyuki
H
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009617:Nocardia Infections / Q000188:drug therapy*; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D013420:Sulfamethoxazole / Q000097:blood; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D013420:Sulfamethoxazole