How does trimethoprim-sulfamethoxazole's efficacy against S. pyogenes influence your empirical treatment of skin infections in regions with high resistance rates?

McCreary et al., PMID 37310038

Answer from: at Community Practice

Recommendations against using trimethoprim-sulfamethoxazole (TMP/SMX) for group A strep (GAS) skin and soft tissue infections (SSTIs) likely stemmed from a misconception that GAS is inherently resistant to the drug. Older studies reporting resistance used media containing a high thymidine concentrat...

Comments

at Stanford Health Care
Agree completely with Dr. @Smith's answer which re...

at Yale New Haven Hospital
I’m not convinced because the PD of T/S is s...

at Robert Wood Johnson University Hospital
For empiric treatment of purulent SSTI, if I use t...

at Crossroads Virology
With Linezolid being generic and cheap, and having...

Answer from: at Community Practice

I am a little confused by the question. Why would you use TMP/SMX monotherapy for SSTI? During the emergence of CA-MRSA, cephalexin with or without TMP/SMX had the same efficacy rates (Pallin). I agree with Dr. @Kaspar; linezolid is a great choice if MRSA is a concern. Cephalexin or cefadroxil are f...

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How does trimethoprim-sulfamethoxazole's efficacy against S. pyogenes influence your empirical treatment of skin infections in regions with high resistance rates?

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