Trimethoprim/sulfamethoxazole for treatment of severe Staphylococcus aureus infections

Abstract

Objective: To evaluate the role of trimethoprim/sulfamethoxazole (TMP/SMX) as an alternative to vancomycin for the treatment of severe Staphylococcus aureus infections.

Data sources: Clinical literature was accessed through MEDLINE (1966-February 2003) and EMBASE (1980-February 2003). Key search terms included trimethoprim/sulfamethoxazole combination and Staphylococcus aureus.

Data synthesis: An evaluation of case reports, case series, and clinical studies focusing on the use of TMP/SMX for treatment of severe S. aureus infections was conducted. The majority of the reports indicate that TMP/SMX may be effective for the treatment of infections due to low bacterial burdens of susceptible strains of S. aureus.

Conclusions: In select infections, TMP/SMX may be a useful alternative to vancomycin for treatment of severe S. aureus infections. Additional randomized studies should be conducted comparing this agent with vancomycin and linezolid.