Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D00285 (Trimethoprim-sulfamethoxazole)
 381 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections are an almost inevitable complication of human bone marrow transplantation and account for the majority of deaths in transplant recipients. Even prior to the initiation of the transplantation procedure, patients may present with infections complicating previously unsuccessful chemotherapy for hematological malignancy or aplastic anemia. Nevertheless, these pre-transplantation infections should not exclude the possibility of bone marrow transplantation if they can be successfully controlled with specific antimicrobial therapy and necessary adjunctive measures. The immediate post-transplantation period prior to engraftment is characterized by severe marrow aplasia that results from high-dose chemotherapy and total-body irradiation. Infections are primarily septicemias and localized processes caused by bacteria and fungi and their incidence increases as the intensity of immunosuppression is escalated. The high mortality associated with bacterial septicemia makes early, empirical antibacterial therapy mandatory. However, the reduction in mortality from bacterial infection resulting from such an aggressive approach may be offset by a higher mortality from invasive fungal infection, especially in patients with prior fungal colonization and undergoing prolonged conditioning therapy. Thus, until more specific and sensitive tests for the diagnosis of invasive fungal infection become available, empirical intravenous amphotericin should be considered in patients who are persistently febrile and deteriorate clinically in the face of appropriate antibacterial therapy. Interstitial pneumonia associated with severe GVHD is the major infectious complication after successful marrow engraftment and is the most significant barrier to long-term survival. Trimethoprim-sulfamethoxazole is effective prophylaxis against interstitial pneumonia due to Pneumocystis carinii, but one half of the patients still develop a pneumonitis either associated with CMV or of unknown etiology. Mortality from interstitial pneumonia is related to prior radiation therapy while survival is associated with a four-fold rise in CMV CF antibody titer. The latter observation supports the need to investigate passive immunization with CMV antibody as a means of preventing some interstitial pneumonias. Despite the progress made in many areas of human bone marrow transplantation, the majority of graft recipients still die of infectious complications. Thus, new approaches to the management of infections in transplant recipients are urgently needed. Better-tolerated oral nonabsorbable antibiotics, laminar-air-flow rooms, granulocyte transfusions, and chemotherapy and immunotherapy for CMV are among the prophylactic and therapeutic measures that must be critically evaluated in well-controlled, prospective studies. Continued assessment of the infectious complications of bone marrow transplantation is a critical aspect of any ongoing transplant program, not just a research goal...
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PMID:Infectious complications of human bone marrow transplantation. 36 7

Infection in the granulocytopenic patient is often life-threatening, and the frequency and severity of infection are increased regardless of the cause of leukocyte suppression. Trimethoprim-sulfamethoxazole plus nystatin is known to be effective in preventing colonization and infection by the primary pathogens responsible for the morbidity and mortality associated with granulocytopenia. When treating granulocytopenic patients, clinicians should use proper barrier techniques to minimize nosocomial colonization. When foci of oral infection are present or bacteremia is predictable, appropriate antibiotics should be prescribed.
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PMID:The granulocytopenic patient: another consideration for antimicrobial prophylaxis. 316 30

The therapeutic effectiveness of a single oral dose (60 and 200 mg/kg body weight) of fosfomycin trometamol (FT), norfloxacin, trimethoprim sulfamethoxazole (Bactrim) and pipemidic acid against experimental cystitis in the rat were compared. Infections were produced with clinical isolates of Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli in a total of 135 Sprague-Dawley albino rats. Oral treatment with all four drugs consistently lowered the numbers of CFU in bladder tissue, especially E. coli and P. mirabilis. Fosfomycin trometamol appeared to be as effective as norfloxacin for treatment of E. coli cystitis even thoughs its minimal inhibitory concentration (MIC) in vitro is 100 times greater than that of the quinolonic antibiotic. Fosfomycin trometamol, pipemidic acid and Bactrim were equally effective against P. mirabilis infection, but FT was less active than norfloxacin or Bactrim for treatment of K. pneumonia cystitis. In conclusion, single dose treatment with fosfomycin trometamol was effective for treatment of experimental cystitis in the rat and might, by extrapolation, be of use in clinical practice for single dose treatment of uncomplicated urinary tract infections.
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PMID:Treatment of experimental cystitis in the rat with a single dose of fosfomycin trometamol. 325 10

Trimethoprim-sulfamethoxazole in vitro activity was compared with ampicillin, tetracycline, sulfonamide and trimethoprim against isolates of 24 gram-negative and 11 gram-positive species. The incidence of more than 10% of strains with minimal inhibitory concentrations above 32 mg/l was restricted to Escherichia coli, Shigella spp., Klebsiella pneumoniae, Providencia rettgeri, Morganella morganii, methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. Occasionally, Streptococcus pneumoniae and Haemophilus influenzae strains with MICs above 32 mg/l were identified. Co-trimoxazole in vitro activity was superior to the comparative drugs for the majority of species. Co-trimoxazole remains an active combination against major pathogens of infections of the upper and lower respiratory, urinary tract and enteric infections with a still low incidence of resistant organisms.
Infection 1987
PMID:Microbiological perspectives of co-trimoxazole. 332 34

Trimethoprim-sulfamethoxazole (co-trimoxazole) is used extensively for treatment of pulmonary and urinary tract infections. Side effects may affect skin, blood, bone marrow, kidney and the liver. Although a number of sulfonamides have been reported to have produced hepatic lesions, hepatitis following therapy with trimethoprim-sulfamethoxazole is a rather rare event. While trimethoprim has not yet been reported as a cause of hepatic disorders, sulfamethoxazole has occasionally been described as inducing hepatic injury. In some cases, these reactions are accompanied by symptoms indicative for allergic reactions such as fever, rash and eosinophilia. Seven well documented cases are analyzed and discussed with respect to the nature of side effects caused by co-trimoxazole.
Infection 1987
PMID:Co-trimoxazole-induced hepatic injury--an analysis of cases with hypersensitivity-like reactions. 350 74

Trimethoprim-sulfamethoxazole (TMP-SMZ) has traditionally been employed as an oral formulation for infections in ambulatory pediatric patients. However, therapeutic concentrations of TMP and SMZ in serum and CSF are more consistently attained after intravenous administration. Serum half-life increases with the age of the child, and few significant toxic effects are observed with intravenous administration. Either the necessity to optimize bioavailability because of the underlying seriousness of disease or a desire to avoid other drugs that may be responsible for adverse reactions or hypersensitivity should direct the clinician to administer an intravenous preparation. Serious pediatric infections that might warrant the consideration of intravenous TMP-SMZ include shigellosis, salmonellosis, typhoid fever, nocardiosis, gram-negative bacillary septicemia or meningitis, and infections due to Pneumocystis carinii and malarial parasites. Infections due to Listeria will respond to TMP-SMZ, and infections due to Citrobacter diversus, Acinetobacter species, Pseudomonas cepacia, and Flavobacterium meningosepticum are especially susceptible to TMP-SMZ.
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PMID:Use of trimethoprim-sulfamethoxazole in pediatric infections: relative merits of intravenous administration. 355 55

In a previous study we demonstrated that trimethoprim-sulfamethoxazole decreases the prevalence of infection in patients with severe granulocytopenia. However, treatment was accompanied by a relatively high incidence of multiresistant microorganisms. We therefore conducted this study to determine whether the addition of colistin to the trimethoprim-sulfamethoxazole regimen prevents the emergence of these resistant bacteria. Thirty consecutive adult patients with acute non-lymphocytic leukaemia received trimethoprim-sulfamethoxazole plus colistin p.o. prophylactically. The results of this study were compared with the results of our previously published controlled study. Trimethoprim-sulfamethoxazole plus colistin was as effective as trimethoprim-sulfamethoxazole in preventing infection. However, the addition of colistin significantly reduced the acquisition of and infection by gram-negative bacilli which were resistant to trimethoprim-sulfamethoxazole. Only two patients were colonized with resistant strains, and no infections with these strains were observed. We have concluded that patients with acute non-lymphocytic leukaemia should receive a combination of trimethoprim-sulfamethoxazole plus colistin prophylactically during remission induction treatment.
Infection
PMID:Colistin and trimethoprim-sulfamethoxazole for the prevention of infection in patients with acute non-lymphocytic leukaemia. Decrease in the emergence of resistant bacteria. 660 30

Urinary tract infection remains an important health concern, particularly in women. It is important to differentiate between uncomplicated and complicated infections, because management strategies differ. Women 18 to 65 years of age with manifestations of uncomplicated lower urinary tract infection can be safely and effectively treated with a 3-day course of trimethoprimsulfamethoxazole (Bactrim, Cotrim, Septra) or trimethoprim alone (Proloprim, Trimpex) if pyuria is detected on urinalysis. Patients with any other manifestations require further diagnostic testing and more prolonged therapy. Urine cultures should be obtained only in patients with complicating factors, and urologic evaluation is warranted only if clearly indicated. Recurrent infection may require continuous antimicrobial prophylaxis. Catheter-related infection should be treated only if the patient is symptomatic. Infection in men may require 4 to 6 weeks of therapy because of possible prostatic involvement.
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PMID:Urinary tract infection: emerging insights into appropriate management. 860 6

Trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line drug for prophylaxis and treatment of Pneumocystis carinii pneumonia (PCP) and for prophylaxis of toxoplasmosis in HIV-infected patients. Evidence indicating intolerance related to the dose of SMX led us to examine the efficacy of altered TMP-SMX ratios in a corticosteroid-treated rat model. Infections were assessed by counting P. carinii cysts in lung and by titration of Toxoplasma gondii burdens in tissue culture. For prophylaxis, the reference regimen of 20 mg/kg TMP plus 100 mg/kg SMX was effective. Reduced doses of SMX (5 and 20 mg/kg) effective against PCP were effective against toxoplasmosis, provided the TMP dose was increased to 100 mg/kg. For curative treatment, the reversed ratio of 100 mg/kg TMP plus 20 mg/kg SMX was not effective. These results may provide a basis for altering the TMP-SMX ratios in setting of prophylaxis for both infections, especially in HIV infected patients who often poorly tolerate sulfonamides.
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PMID:Altered trimethoprim-sulfamethoxazole ratios for prophylaxis and treatment of Toxoplasma gondii and Pneumocystis carinii dual infections in rat model. 889 64

In the last decade, a growing number of patients with pneumonia, caused by unusual gram positive rods have been observed. Mostly, the patients had been infected as a consequence of impaired immunity. In some cases, bioterrorist activities may also induce pneumonia by gram positive rods (B. anthracis). In order to bring these organisms to the attention of the medical community, we present three clinical cases and describe six species of gram positive rods, known to provoke this kind of pneumonias. Case 1 was a 84 years old patient with impaired lung function. He was suspicious of tuberculosis (Tbc). Nocardia spec. was isolated. Case 2 was an alcoholic of 46 years with pneumonia. Reactivation of Tbc was suspected. Actinomadura madurae has been isolated. Case 3 was a patient of 58 years with myelodysplastic syndrome (MDS) and pneumonia. N. asteroides was isolated. All patients shared impaired immunity (age, alcoholism, MDS) with impaired lung functions; Tbc had been suspected (Case 1 + 2). Infection by A. madurae was contained by Clindamycin. Therapy of Nocardia with Moxifloxacin (Case 1) or Bactrim (Case 3) was only partly effective. In the appendix, six species of gram positive rods which are known to cause pneumonia, are summarized (Nocardia, Actinomyceta, Actinomadura, Rhodococcus, Corynebacterium and Bacillus).
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PMID:[Unusual gram positive rods, causing pneumonia]. 1278 78


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