No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

A 32-year-old man presented with epigastric pain. He had a previous episode of acute pancreatitis of undetermined cause 2 years earlier. The patient had taken trimethoprim (80 mg) and sulfamethoxazole (400 mg) twice daily because of acute urethritis 3 days prior to admission. No definite cause of acute pancreatitis could be identified on baseline studies. A thorough history-taking revealed that the patient had an episode of acute pancreatitis while taking trimethoprim (80 mg) and sulfamethoxazole (400 mg) twice daily for 2 weeks for prostatitis prior to the previous admission. Therefore, a cause-and-effect relationship between trimethoprim-sulfamethoxazole (TMP-SMX) and repeated episodes of pancreatitis was highly suggested. The patient was presumably diagnosed as TMP-SMX-induced pancreatitis. The final diagnosis was TMP-SMX-induced pancreatitis. Since drugs are rare causes of acute pancreatitis and the diagnosis of drug-induced pancreatitis is difficult to establish, we report this interesting case along with a review of medical literature.
Adult ; Humans ; Pancreatitis ; Prostatitis ; Sulfamethoxazole ; Trimethoprim ; Urethritis ; Trimethoprim, Sulfamethoxazole Drug Combination

In spite of highly developed antibiotics and chemotherapeutics, genitourinary tract infection still remains as troublesome subjects for urologists. New bactericidal agent, Bactrim (trimethoprim-sulfamethoxazole) was administered in 18 cases of genitourinary tact infection, which were resistant to most antibiotics and following results were obtained. 1) Among 9 cases of non-gonococcal urethritis. 5 cases were cured completely, 4 cases were improved. 2) Among 7 cases of chronic prostatitis, one case was cured but only mild improvement were noted in remaining 6 cases. 3) 2 cases of pyelonephritis showed improvement in both clinically and bacteriologically.
Anti-Bacterial Agents ; Prostatitis ; Pyelonephritis ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Urethritis

A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Ampicillin ; Clone Cells ; Jeju-do* ; Korea ; Plasmids* ; Ribotyping ; Shigella sonnei* ; Shigella* ; Streptomycin ; Sulfamethoxazole ; Tetracycline ; Treatment Failure ; Trimethoprim, Sulfamethoxazole Drug Combination

A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Ampicillin ; Clone Cells ; Jeju-do* ; Korea ; Plasmids* ; Ribotyping ; Shigella sonnei* ; Shigella* ; Streptomycin ; Sulfamethoxazole ; Tetracycline ; Treatment Failure ; Trimethoprim, Sulfamethoxazole Drug Combination

Adverse reactions to drugs are more common in HIV infected patients. Hypersensitivity to trimethoprim-sulfamethoxazole (TMP/SMZ) during treatment or prophylaxis of Pneumocystis carinii pneumonia (PCP) is the most frequent drug reaction of HIV infection. Although less extensively documented than sulphonamides, other drugs also seem to induce drug reactions in HIV-seropositive patients more than in other groups. Rifampin is an essential anti-tuberculosis medication; thus, desensitization of rifampin is especially necessary in our country in which mycobacterial infection is common. We report two cases of AIDS patients with pulmonary tuberculosis who have rifampin hypersensitivity whose rifampin treatment will end successfully through rifampin desensitization.
HIV ; HIV Infections ; Humans ; Hypersensitivity* ; Pneumonia, Pneumocystis ; Rifampin* ; Trimethoprim, Sulfamethoxazole Drug Combination ; Tuberculosis, Pulmonary

PURPOSE: To compare the efficacy and safety of a 3-day regimen of extended-release ciprofloxacin (ciprofloxacin ER), 500mg qd, with trimethoprim-sulfamethoxazole (TMP/SMX), 800mg/160mg bid, for the empirical treatment of acute uncomplicated cystitis in Korean women. MATERIALS AND METHODS: A randomized, single-blind treatment trial of 75 women with acute uncomplicated cystitis was conducted. The women were prescribed ciprofloxacin ER, 500mg qd, or TMP/SMX, 800mg/160 mg, bid for 3 days. The patients were assessed in terms of the clinical and microbiological outcome and safety 7 days after treatment. RESULTS: Sixty-five women were eligible for the analyses (32 ciprofloxacin ER and 33 TMP/SMX). The most prevalent causative organism was Escherichia coli (76.9%), followed by Proteus (6.2%) and coagulase-negative Staphylococcus (6.2%). The rates of in vitro susceptibility to ciprofloxacin and TMP/SMX were 86.2 (56/65) and 73.4% (48/65), respectively. The clinical cure rates with ciprofloxacin ER and TMP/SMX were 87.5 and 78.8%, respectively. Microbiological cures at 7 days were observed in 25 of the 32 (78.1%) with ciprofloxacin ER and 18 of the 33 (54.5%) with TMP/SMX. The mean interval to improvement in the clinical symptoms after ciprofloxacin and TMP/SMX medications were 1.93+/-0.55 and 2.92+/-0.48 days, respectively. Adverse events with ciprofloxacin and TMP/SMX occurred in 28.1 and 15.5%, respectively, but both treatments were well tolerated. CONCLUSIONS: Although some organisms were resistant (13.8%) to ciprofloxacin, ciprofloxacin ER was superior to TMP/SMX in terms of the clinical and microbiological cure rates and the mean interval to improvement in the clinical symptoms. The high prevalence of resistance and low microbiological cure rates for TMP/SMX suggest that this drug does not provide an adequate initial therapy, while once-daily ciprofloxacin ER was safe and effective in the empirical treatment of symptomatic uncomplicated cystitis.
Ciprofloxacin* ; Cystitis* ; Escherichia coli ; Female ; Humans ; Prevalence ; Proteus ; Staphylococcus ; Trimethoprim-Sulfamethoxazole Combination

Nocardia brain abscess is rare. We report on a unique case of N. farcinica brain abscess in a liver transplant recipient, following Aspergillus fumigatus pneumonia. A 43-year-old liver transplant recipient presented with altered mentality at 2 months after A. fumigates pneumonia. He was successfully treated with surgical removal and antibiotic therapy with trimethoprim-sulfamethoxazole and ceftriaxone.
Adult ; Aspergillus fumigatus ; Brain ; Brain Abscess ; Ceftriaxone ; Humans ; Liver ; Nocardia ; Pneumonia ; Transplants ; Trimethoprim, Sulfamethoxazole Drug Combination

Forty-Five cases of Shigellosis were treated with Ampicillin, TMP/SMX and Rifampin from April 1980. to November 1980. Of the 18 strains of shigellae, in-vitro sensitivity test was performed against twelve antimicrobial agents. The percentage of resistant strains was 77.8% in Ampicillin and 100% in TMP/SMX. Inhibition zone diameter by Rifampin disc was 8~10mm in all cases and clinical improvement with treatment was noted in nearly all cases, therefore we regarded inhibition zone diameter above 8mm sensitive to Rifampin. In clinical evaluation, the percentage of effectiveness by antibiotics was as follows; Ampicillin-60%, TMP/SMX-70% and Rifampin-93.3%. Rifampin appears to be the best, available drug bacteriologically and clinically for the treatment of Shilgellosis.
Ampicillin* ; Anti-Bacterial Agents ; Anti-Infective Agents ; Dysentery, Bacillary* ; Humans ; Rifampin* ; Shigella ; Trimethoprim, Sulfamethoxazole Drug Combination*

From August to November 1985 244 bacteriologically proven male uncomplirated goncicoccal urethritis patients at the VD clinic of Choong-Ku Public Health Center form August to November 1985 were divided into group A and group B according to a random number sheet. In group A, treated with kanamycin 2.Ogm, im plus benzyl penicillin-G 5 mega units, im plus probenecid, 1.Ogm, PO; 112 of 121 patients were followed and 10 patients (8.9%) failed to be recovered. In group B, treated with kanamycin, 2,Ogm, im plus trimethoprim-sulfamethoxazole, 9 tahlets, PO; 112 of l23 patients were followed and 7(6.3%) failed. There is no sign.ificant difference between the two groups (p>0. 05) The failure rates in PPNG urethritis were 14.3% and 8.0% in group A and group B respectively. There is a signficant difference in failure rate between the two groups (P<0.05). It is suggested that, because of high rate of PPNG among circulating N.gonorrhoeae, the combinatioin regimen of kanamycin and trime.thoprim-sulfamethoxazole may be used as a first line treatrnent regimen for uncomplicated gonococcal urethritis.
Gonorrhea* ; Humans ; Kanamycin* ; Male ; Penicillin G* ; Penicillins* ; Probenecid* ; Public Health ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Urethritis