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Pulmonary nocardiosis may develop in individuals with chronic pulmonary disease or immunosuppression. Trimethoprim-sulfamethoxazole (TMP-SMX) has been established as first-line treatment, but the appropriate dose remains controversial. The traditionally recommended high-dose TMP-SMX (typically 15 mg/kg/day of TMP) has been adopted from pneumocystis pneumonia treatment, but successful management has also been achieved with lower doses. Now, Mayo Clinic researchers have conducted a retrospective cohort study of TMP-SMX treatment for non-disseminated pulmonary nocardiosis involving 91 patients (median age, 70.5); predisposing factors included chronic lung disease (70%), use of immunosuppressant medication (34%), solid-organ transplantation (10…