Trimethoprim-Sulfamethoxazole — Not Good for Severe Staph Infections

In a randomized, controlled trial conducted in Israel, trimethoprim-sulfamethoxazole did not prove noninferior to vancomycin for treating severe MRSA infections, particularly bacteremia.

Vancomycin is the antibiotic most frequently used to treat severe methicillin-resistant Staphylococcus aureus (MRSA) infections. The difficulty of monitoring vancomycin levels in vivo, the possibility of reduced effectiveness because of minimum inhibitory concentration “creep,” and toxicity issues have spurred a search for alternatives. MRSA is usually sensitive to trimethoprim-sulfamethoxazole (TMP/SMX), and this drug has been very effective in treating MRSA skin infections. But how does it compare with vancomycin for treatment of severe MRSA infections, such as bacteremia or pneumonia?

To explore this question, researchers in Israel conducted an open-label, controlled trial involving patients with such infections. A total of 252 participan…

Reviewing Author

Stephen G. Baum, MD

Disclosures

Consultant/Advisory BoardClinical Infectious Diseases

RoyaltiesUpToDate

Editorial BoardsMedical Letter

Stephen G. Baum, MD

Disclosures

Consultant/Advisory BoardClinical Infectious Diseases

RoyaltiesUpToDate

Editorial BoardsMedical Letter

Trimethoprim-Sulfamethoxazole — Not Good for Severe Staph Infections

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Reviewing Author