• Asian-Australasian Journal of Animal Sciences
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• v.4 no.3
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• pp.281-284
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• 1991

Combination effects of sulfamethoxazole (SMX) and trimethoprim (TMP) against nine gram positive bacterial strains and 43 gram negative bacterial strains which included 40 strains of animal intestinal bacteria were studied in vitro. Minimum inhibitory concentrations (MICs) of SMX and TMP alone and 20:1 (SMX : TMP) mixture (ST) were investigated by the method recommended by Ad Hoc Committee of the Japan Society of Chemotherapy for the Evaluation of Sensitivity Testing Methods for Sulfamethoxazole and Trimethoprim. MICs of ST were more potentiated than those of SMX alone in 8 of 9 gram positive strains and 40 of 43 gram negative strains. Especially, 38 strains of 40 intestinal bacteria showed significant susceptibility to ST as compared to SMX. These results suggest a strong synergistic activity of ST mixture against animal intestinal bacteria, The activity was considered to be comparable to those of other current antibiotics.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.273-278
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• 2013

We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.

• Parasites, Hosts and Diseases
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• v.41 no.1
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• pp.57-61
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• 2003

Total of 7,495 children including 3,908 boys and 3,587 girls from a kindergarten and 15 primary schools were examined for head lice infestation (HLI). The overall prevalence of HLI in this study was found to be 5.8%. Head lice were much more commonly detected in girls than in boys with prevalence of 11.2% and 0.9%, respectively. Sixty-nine children with HLI were treated with 1% lindane shampoo alone (group 1), and 45 children with HLI were treated with 1% lindane shampoo and oral trimethoprim/sulfamethoxazole (group 2), and follow-up visits were conducted 2 and 4 weeks later, The children who still had HLI 2 weeks after the primary treatment were treated again. At the 2-week follow-up visit, the treatment success rates of groups I and 2 were 76.8% and 80.7%, respectively, and at the 4-week follow-up visit, the rates were 91.3% and 97.8%, respectively. No statistically significant synergistic effect was observed for the combination of a 1% lindane shampoo and oral trimethoprim/sulfamethoxazole.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.89-92
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• 2007

Burkholderia cepacia is a Gram-negative aerobic bacillus known to cause opportunistic infections in the immune-compromised hosts. This microorganism is strongly virulent and causes a necrotising invasive infection that may lead to death. As B. cepacia is highly resistant to various antimicrobials, combination antimicrobial therapy must be used instead of monotherapy. We report a successful treatment of lung abscess that was naturally caused by B. cepacia in a healthy child, through combination antimicrobial therapy of meropenem and trimethoprim/sulfamethoxazole and operative management.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.101-103
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• 2016

Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity.

• Journal of Microbiology and Biotechnology
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• v.25 no.9
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• pp.1559-1567
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• 2015

The combination of trimethoprim (TMP) and sulfamethoxazole (SMX) has been shown to be active against Mycobacterium tuberculosis (Mtb) in clinical tuberculosis (TB) treatment. However, the mechanism of action of TMP-SMX against Mtb is still unknown. To unravel this, we have studied the effect of TMP and SMX by deleting the folP2 gene in Mycobacterium smegmatis (Msm), and overexpressing the Mtb and Msm folP1/2 genes in Msm. Knocking out of the folP2 gene in Msm reduced the minimum inhibitory concentration of SMX 8-fold compared with wild type. Overexpression of the folP1 genes from Mtb and Msm increased the MICs by 4- and 2-fold in Msm for SMX and TMP, respectively. We show a strong correlation between the expression of folP1 and folP2 genes and TMP-SMX resistance in mycobacteria. This suggests that a combination of FolP2 inhibitor and SMX could be used for TB treatment with a better outcome.

• Korean Journal of Veterinary Research
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• v.39 no.2
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• pp.376-382
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• 1999

A methicillin-resistant Staphylococcus aureus (MRSA) isolate was recovered from a 9-month-old female Shih-Tzu dog with canine distemper virus infection. We performed in vitro antimicrobial susceptibility test to determine the most effective antimicrobial drug against the isolate and thus, to emphasize its potential clinical importance in animal practices. Isolate was confirmed MRSA by oxacillin agar screening test. The isolate was fully resistant to all $\beta$-lactam antibiotics and was susceptible to glycopeptides. Of the other antibiotics, mupirocin, TMP/SMZ (trimethoprim-sulfamethoxazole), and chloramphenicol showed inhibitory effect at the concentration of 4x MIC. The MICs ranged 0.25->$128{\mu}g/ml$, and MBCs ranged 0.5->$128{\mu}g/ml$. The combined TMP/SMZ with cefamandole or novobiocin showed synergistic effect, whereas the combination of novobiocin plus cefamandole or teicoplanin resulted in antagonistic effects. Although MRSA in animals so far has been reported in the geographically limited countries, at least theoretically, it could be occurred in the future more frequently through either human or animal origin. The use of this combination may be of value in this situation. As with all antimicrobial agents, inappropriate or unnecessarily prolonged therapy may contribute to the emergence of resistance strains and loss of efficacy.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.109-111
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• 2013

Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a major complication of peritoneal dialysis (PD) and leads to the discontinuation of PD. Despite its limited pathogenicity, CAPD peritonitis caused by Stenotrophomonas maltophilia (S. maltophilia), an important nosocomial pathogen that is present in nature and is usually associated with plastic indwelling devices. Infection of S. maltophilia is associated with a poor prognosis, including inability to maintain the CAPD catheter, because of its resistance to multiple antibiotics. We report a case of CAPD peritonitis due to S. maltophilia that was treated successfully using oral Trimethoprim-sulfamethoxazole and intraperitoneal Ticarcillin/clavulanate without removing the dialysis catheter.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.330-334
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• 2006

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.698-701
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• 2007

We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.