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Trimethoprim and sulfamethoxazole were tested individually and in combination against El Tor and classical biotype strains of Vibrio cholerae. Determinations of the minimal inhibitory concentration in liquid media and by an agardilution method showed that classical strains were uniformly more resistant to sulfamethoxazole than were El Tor strains. In agar-dilution studies, trimethoprim was equally active against both biotypes. Combination of the agents produced a synergistic action against all strains tested. Testing for susceptibility to sulfonamide is suggested as a possible method for differentiating between El Tor and classical biotypes of V. cholerae.
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We report a case of prostatic malacoplakia in a 68-year-old man complaining of fever, residual urinary sensation and small urinary stream. Culture of the urine showed E. coli and Enterococcus faecalis. Digital examination and transrectal ultrasound of the prostate were most compatible with carcinoma. However, transrectal needle biopsy revealed the histopathological features of malacoplakia. The patient had been treated with trimethoprim-sulfamethoxazole, bethanechol and ascorbic acid for 5 months. Twenty-seven cases of prostatic malacoplakia in the Japanese literature are reviewed.
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This trial assessed the efficacy of cotrimoxazole lock solution in reducing catheter-related blood stream infections (CRBSIs) among hemodialysis (HD) patients who were dialyzed using tunneled catheters.
In patients with chronic obstructive airway disease, the elimination half-lives of tetroxoprim (TXP) and sulfadiazine (SDZ) were found to be 8.6-9.0 h and 7.9-8.5 h, respectively, after administration of a single dose. The corresponding values for trimethoprim (TMP) and sulfamethoxazole (SMZ) were found to be 13.7 and 15.7 h, respectively. In the case of therapeutic multiple dosing, TMP and SMZ accumulate in patients' serum (tau = 12 h). Over a 10-day period of investigation, the serum levels measured were used to calculate half-life values of 12.9 h for TMP and 10.7 h for SMZ. Under the conditions of steady state, half-lives of 5.0 and 5.6 h were calculated for TXP and SDZ, respectively, which in the case of TXP might be explained kinetically. Due to the parallel change in the elimination-rate constants, no accumulation of TXP and SDZ in patients' serum (tau = 12 h) can occur.
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Thirty-four privately owned sulphonamide HS dogs, 10 sulphonamide-'tolerant' dogs, 18 sulphonamide-naïve dogs, and four dogs experimentally dosed with SMX and the oxidative metabolite SMX-nitroso, were tested for drug-serum adducts by immunoblotting, and anti-drug antibodies by ELISA.
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Necrotizing nocardial scleritis can be treated by surgical debridement and systemic TMP-SMX and topical PAI.
Isospora belli infection is frequent in patients with acquired immunodeficiency syndrome in tropical areas. It has also been reported in other immunodepressive diseases, such as lymphoblastic leukemia, adult T-cell leukemia, and Hodgkin's disease. To date, no case of non-Hodgkin's lymphoma-related isosporiasis has been reported in a non-HIV-infected patient. We describe a case of non-Hodgkin's lymphoma with chronic diarrhea due to I. belli. In Europe, I. belli can cause severe chronic diarrhea in patients with malignancies whose country of origin is in an endemic area. Trimethoprim-sulfamethoxazole can provide rapid and prolonged clinical and parasitologic cure.
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TLR4 expression is decreased in patients with Child-Pugh C cirrhosis, but is restored by antibiotics targeting enteric Gram-negative bacteria. TLR4-dependent cytokine production also increases significantly following antibiotic therapy. This suggests that the high incidence of Gram-negative infection in cirrhotic patients is in part due to down-regulation of the TLR4-dependant immune response and that the efficacy of antibiotic prophylaxis is contributed to by modulation of innate immunity.
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Thrombocytopenia associated with TMP/SMX therapy can be serious or life threatening because it may result in significant bleeding complications. This hematologic adverse effect of TMP/SMX may occur even with the usual recommended dosage and duration of therapy. Careful monitoring of complete blood cell count, including platelet count, before and during TMP/SMX therapy is suggested.