Rifampicin plus Trimethoprim-Sulfamethoxazole Noninferior to Linezolid for MRSA Infections

Methicillin-resistant Staphylococcus aureus (MRSA) poses a major healthcare burden in many countries. The standard treatment for MRSA infections — vancomycin — requires intravenous administration and thus hospitalization in most cases. Oral linezolid has shown good absorption and anti-MRSA activity, but high cost, drug interactions, and adverse events limit its use. Trimethoprim/sulfamethoxazole (TMP/SMX), administered orally with or without rifampicin, is also well absorbed and has good anti-MRSA activity, but is it as efficacious as linezolid?

In a recent open-label, single-center, noninferiority trial conducted in Switzerland between January 2009 and December 2013, researchers sought to answer this question. Participants — 150 adults with…