Of the total 328 patients, 35% received ciprofloxacin, 24% cefazolin, 3% gentamicin, 1% TMP-SMX
and 1% nitrofurantoin.
For example, although TMP-SMX
and doxycycline are first-line drugs for treatment of melioidosis in disease-endemic regions, researchers in other parts of the world consistently use trimethoprim and tetracycline (which leads to cross-resistance with doxycycline) as markers.
coli resistance to TMP-SMX
doubled, from 9% to 18%, while resistance to nitrofurantoin and ciprofloxacin remained unchanged, at 0%-2% for the entire study period (JAMA 1999;281:736-8).
Alternatively empiric treatment with both TMP-SMX
and acyclovir together with steroids can be initiated and therapy can be modified once laboratory results become available for both PCP and HSV.
The best estimate for moderate adverse events from TMP-SMX
is based on a study that cited 3.
Nitrofurantoin, the IDSA said at the time, "may become more useful as resistance to TMP-SMX
increases," but was not considered first-line because of concerns about effectiveness (85% cure rate versus 90%-95% for other first-line agents) and safety, particularly regarding the rare but potentially serious occurrence of acute pulmonary reaction and the even rarer peripheral neuritis.
Recent studies indicate that TMP-SMX
resistance "may be leveling off" after peaking at about 25%, which is probably because of the reduced use of this treatment, she said.
Brusellozun tedavisinde osteoartikuler hastaligi, norobrusellozu veya endokarditi olmayan 8 yas alti cocuklar oral TMP-SMX
ve rifampin ile 4-6 hafta; 8 yas ve uzeri cocuklar ise oral tetrasiklin ve rifampin ile 6 hafta tedavi edilmelidir (3, 7-10).
Organisms that were resistant to all of the following were classified as multidrug-resistant organisms: ampicillin, amoxicillin-clavulanate, cefotaxime, gentamicin, tetracycline, trimethoprim and TMP-SMX
There was no significant difference for rifampin, TMP-SMX
, or vancomycin.
The standard treatment of uncomplicated cystitis is 3 days of double-strength formulations of TMP-SMX
twice a day.
Most experts agree that it's usually better to start with the simpler, less expensive antibiotics with which clinicians are likely to have the most familiarity, such as amoxicillin, amoxicillin/clavulanate, or TMP-SMX
, reserving fluoroquinolones and cephalosporins for more severe or resistant disease.