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Idiopathic pulmonary fibrosis (IPF) has limited treatment options and poor prognosis. Findings of pathologic bacterial burden in the lungs of patients with IPF led to small treatment trials of trimethoprim-sulfamethoxazole (TMP/SMX) with encouraging results. A larger multicenter U.K. trial was conducted by randomizing 341 patients with moderate-to-severe IPF (forced vital capacity, ≤75% predicted) to TMP/SMX or placebo. Patients were treated until they reached a study endpoint (i.e., death, lung transplant, or emergency hospitalization) or study end (median, 12 months).
Study endpoints occurred with similar frequency in the intervention and control groups (0.45 and 0.38 per person-year, respectively); median survival also was similar. The au…