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Outpatient Trimethoprim-Sulfa Use
Consumption is shifting to parts of the South
BACKGROUND
Trimthoprim-sulfamethoxazole (TMP-SMZ, also known as co-trimoxazole) is a combination of a sulfonamide and trimethoprim in a 5-1 ratio. Antibacterial sulfonamides interfere with the production of folate through inhibition of enzyme production. Both compounds are bacteriostatic – that is, they stop bacterial growth – but they depend on the immune system to kill remaining organisms. TMP-SMZ is indicated for the prophylaxis and treatment of urinary tract infections. Other uses include enterocolitis, traveler’s diarrhea, and acute otitis media.
TMP-SMZ enjoys high popularity in North America despite the emergence of resistance. However, its use is limited in some European countries due to risks of rare but severe allergic reactions such as toxic epidermal necrolysis. Around the world, co-trimoxazole is still widely used for prophylaxis and treatment of opportunistic infections in patients with AIDS, children born to HIV-infected mothers, and patients undergoing organ transplantation.
A REGIONAL PICTURE OF ANTIBIOTIC CONSUMPTION
