| Title | Tuberculosis and Trimethoprim-Sulfamethoxazole. | | Author(s) | Forgacs P, Wengenack NL, Hall L, Zimmerman SK, Silverman ML, Roberts GD | | Institution | From the Departments of Infectious Diseases (Emeritus) and Research, Clinical Microbiology and Anatomic Pathology, Lahey Clinic Medical Center, Burlington, Massachusetts; and the Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota. | | Source | Antimicrob Agents Chemother 2009 Jun 29. | | Abstract | The sulfonamides were the first drugs with antituberculous effect. Their use was abandoned and basically forgotten with the advent of streptomycin and isoniazid combination treatment. There is a widespread belief, based apparently on testing a single isolate on questionable media, that Mycobacterium tuberculosis is resistant to trimethoprim-sulfamethoxazole. We saw a complex patient with tuberculosis, who was initially treated with trimethoprim-sulfamethoxazole without antituberculous drugs and defervesced on this treatment. His isolate of Mycobacterium tuberculosis was found to be sensitive to trimethoprim-sulfamethoxazole. We examined how frequently Mycobacterium tuberculosis is sensitive to trimethoprim-sulfamethoxazole. Isolates were tested for susceptibility to trimethoprim-sulfamethoxazole on supplemented Middlebrook 7H10 plates. We found that 43 of 44 (98%) of isolates of M. tuberculosis were susceptible to the combination of </= 1microg/ml of trimethoprim and 19microg/ml of sulfamethoxazole (</=1/19microg/ml). Thus the vast majority of our M. tuberculosis isolates were susceptible to trimethoprim-sulfamethoxazole at an MIC similar to M. kansasii, M. marinum and sensitive rapidly growing mycobacteria, organisms successfully treated with trimethoprim-sulfamethoxazole as part of the treatment regimen. In an era of multiple and extended drug resistance in tuberculosis (MDR and XDR), it is possible that trimethoprim-sulfamethoxazole may be a useful drug in treating patients with such resistant tuberculosis cases. We feel that a clinical trial looking at the effectiveness of TMP-SMX as an antituberculous drug is worthwhile. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19564358 |
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