This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (26)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Bacterial Infections  • HIV/AIDS  • Pulmonary Diseases, Other  • Urinary Tract Disorders  • Review  • Adverse Effects  • Drug Therapy, Other  • Alert me on articles by topic

Philip A. Masters, MD; Thomas A. O'Bryan, MD; John Zurlo, MD; Debra Q. Miller, MD; Nirmal Joshi, MD

Arch Intern Med. 2003;163:402-410.

During the past 3 decades, the combination of trimethoprim and sulfamethoxazole has occupied a central role in the treatment of various commonly encountered infections and has also been particularly useful for several specific clinical conditions. However, changing resistance patterns and the introduction of newer broad-spectrum antibiotics have led to the need to carefully redefine the appropriate use of this agent in clinical practice. While trimethoprim-sulfamethoxazole's traditional role as empirical therapy for several infections has been modified by increasing resistance, it remains a highly useful alternative to the new generation of expanded-spectrum agents if resistance patterns and other clinical variables are carefully considered. It also seems to have an increasing role as a cost-effective pathogen-directed therapy with the potential to decrease or delay development of resistance to newer antibiotics used for empirical treatment. In addition, trimethoprim-sulfamethoxazole continues to be the drug of choice for several clinical indications.

From the Divisions of General Internal Medicine (Drs Masters, O'Bryan, Miller, and Joshi) and Infectious Diseases (Dr Zurlo), The Pennsylvania State University College of Medicine, Hershey.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Streptococcus pneumoniae: An Update on Resistance Patterns in the United States
Starr et al.
Journal of Pharmacy Practice 2008;21:363-370.
ABSTRACT  

The past, present and future of antifolates in the treatment of Plasmodium falciparum infection
Nzila
J Antimicrob Chemother 2006;57:1043-1054.
ABSTRACT | FULL TEXT  

Transient Psychosis in an Immune-Competent Patient After Oral Trimethoprim-Sulfamethoxazole Administration
Saidinejad et al.
Pediatrics 2005;115:e739-e741.
ABSTRACT | FULL TEXT  

Trimethoprim/Sulfamethoxazole: Clinical Update
Libecco and Powell
Pediatr. Rev. 2004;25:375-380.
FULL TEXT  

Trimethoprim-Sulfamethoxazole-Induced Life-Threatening Agranulocytosis
Andres et al.
Arch Intern Med 2003;163:1975-1976.
FULL TEXT  

Trimethoprim-Sulfamethoxazole-Induced Life-Threatening Agranulocytosis--Reply
Masters et al.
Arch Intern Med 2003;163:1976-1976.
FULL TEXT