Dose of Trimethoprim-Sulfamethoxazole to Treat Skin and Skin Structure Infections Caused by Methicillin Resistant Staphylococcus aureus.

Link to article at PubMed

Dose of Trimethoprim-Sulfamethoxazole to Treat Skin and Skin Structure Infections Caused by Methicillin Resistant Staphylococcus aureus.

Antimicrob Agents Chemother. 2011 Sep 19;

Authors: Cadena J, Nair S, Henao-Martinez AF, Jorgensen JH, Patterson JE, Sreeramoju PV

Abstract
Objective: We undertook this study to investigate whether treatment with a higher dose of trimethoprim/sulfamethoxazole (TMP/SMX) led to greater clinical resolution in patients with skin and soft tissue infections (SSTI) caused by methicillin resistant Staphylococcus aureus (MRSA). Methods: A prospective, observational cohort with nested case control study was performed at a public tertiary health system. Among patients with MRSA SSTI during May-08 to Sep-08 who received oral monotherapy with TMP-SMX and known clinical outcome, the clinical characteristics and outcomes were compared between patients treated with high dose of TMP/SMX (320mg/1600mg twice daily) for 7-15 days and patients treated with standard dose of TMP/SMX (160mg/800mg twice daily) for 7-15 days. Results: In patients with MRSA SSTI, those treated with high dose of TMP/SMX (n=121) had similar clinical characteristics compared to patients treated with standard dose of TMP/SMX (n=170). The only exception was a higher proportion of patients with history of trauma upon admission in the patients treated with higher dose. The proportion of patients with clinical resolution of infection was not different in the two groups [88/121, 73% vs. 127/170, 75%; p-value=0.79). The lack of significance remained in patients with abscess upon stratified analysis by whether surgical drainage was performed. Conclusion: The study found that patients with MRSA SSTI treated with a higher dose of TMP/SMX 320/1600mg twice-daily for 7-15 days had a similar rate of clinical resolution compared to patients treated with a standard dose of TMP/SMX, 160/800mg twice-daily for 7-15 days.

PMID: 21930870 [PubMed - as supplied by publisher]

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