Synergistic Action of Trimethoprim and Sulfamethoxazole for Nocardia Asteroides: Efficacious Therapy in Five Patients

Adams, Harry G.; Beeler, Barbara A.; Wann, L S; Chin, Celeste Kam; Brooks, George F.

doi:10.1097/00000441-198401000-00002

Cited by 17 publications

(3 citation statements)

References 25 publications

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“…However, given the need to use combinations of antibiotics in severe cases, the possibility of allergic reactions to sulfamides, and the variable susceptibility of the microorganism to these antimicrobial drugs, it is recommended that an antibiogram be produced when isolating Nocardia from a biological sample in order to ensure a suitable treatment regime. The synergistic in vitro effect of trimethoprim/sulphamethoxazole against Nocardia [92], coupled with its good penetration of various tissues and its ability to reach high serum levels following oral administration, have made this combination the treatment of choice for nocardiosis. The recommended doses are 5-15 mg/kg of trimethoprim (TMP) and 25-75 mg/kg of sulphamethoxazole (SMX), depending on the severity of the infection; 2-4 endovenous doses are given at the outset, switching to oral administration when the patient improves.…”

Section: Treatment Outcome and Prophylaxismentioning

confidence: 99%

Infrequent Infections in COPD

Domingo¹,

Masdeu

Gallego

2006

CRMR

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Due to their long survival and high cumulative corticosteroid dose, COPD patients become susceptible to unusual microorganisms that commonly affect immunosuppressed patients. Among them, fungi such as Aspergillus and Pneumocystis jiroveci and a bacterium Nocardia, a slow growing Gram-positive and acid-fast staining filamentous branching rod, have been reported in the last decade.Aspergillus can affect immunocompromised patients in different ways: by colonizing a cavity (aspergilloma), by local chronic invasion of lung parenchyma (chronic necrotizing aspergillosis or semi-invasive aspergillosis) or through a devastating vascular dissemination disease (invasive pulmonary aspergillosis).Nocardia is a pathogen that tends to act opportunistically, although it has also been reported in immunocompetent patients. It causes chronic lung infection, although systemic nocardiosis with or without central nervous system involvement is quite often found.Before the AIDS epidemic, Pneumocystis jiroveci (formerly known as Pneumocystis carinii f.sp. hominis) was known to affect malnourished patients. Recently it has been found colonizing chronic respiratory patients with conditions such as COPD or cystic fibrosis,but its role in the pathogenesis or evolution of COPD deterioration is unknown.The clinical presentation, diagnosis and therapeutic approach of each type of infection is discussed herein.In recent decades, COPD survival has progressively increased and patients have become susceptible to unusual microorganisms, especially due to their high cumulative corticosteroid dose. In this paper we consider two fungi (Aspergillus and Pneumocystis) and one bacterium (Nocardia) not frequently related to pulmonary infections in COPD.

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Section: Treatment Outcome and Prophylaxismentioning

confidence: 99%

Infrequent Infections in COPD

Domingo¹,

Masdeu

Gallego

2006

CRMR

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“…48 Excellent serum levels are achieved with oral administration of oral TMP/SMX 6,122 and both agents penetrate well into cerebrospinal fluid. 6,121,122 Several additional reports have shown that the combination of TMP/SMX may be effective in the treatment of both localized and disseminated nocardiosis, 6,30,80,[121][122][123][124] but failures have also been described. 45 ' 80125126 TMP-SMX alone (or in combination with streptomycin or dapsone plus streptomycin) is effective against other Nocardia species, including N. brasiliensis.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Nocardiosis

Rolfe¹,

Strieter²,

Lynch³

1992

Semin Respir Crit Care Med

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“…Sulfonamides are usually considered the drugs of first choice for therapy of nocardiosis (2,16). Recent studies have demonstrated potent anti-no-cardiaI activity of certain antimicrobial agents (ceftazidime, imipenem, amikacin) and combinations of these drugs (16)(17)(18).…”

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confidence: 99%

A case of testicular nocardiosis and literature review

Torres‐López

Ferrero

Lumbreras

et al. 1994

Eur. J. Clin. Microbiol. Infect. Dis.

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A case of epididymo-orchitis due to Nocardia asteroides in a liver transplant recipient is reported. Nocardiosis is an extremely rare cause of epididymo-orchitis. Four other cases published in the English language medical literature are reviewed. All patients were immunocompromised, and other organs were affected simultaneously. Clinically the infection presented as a painful enlargement of the testicle with few inflammatory signs. Mortality was high (3/5), and in the two survivors long-term sulfonamide therapy was combined with orchiectomy. Nocardiosis should be considered in the diagnosis of epididymo-orchitis in the immunocompromised host.

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Synergistic Action of Trimethoprim and Sulfamethoxazole for Nocardia Asteroides: Efficacious Therapy in Five Patients

Cited by 17 publications

References 25 publications

Infrequent Infections in COPD

Infrequent Infections in COPD

Nocardiosis

A case of testicular nocardiosis and literature review

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