Infectious Diseases Unit, Rabin Medical Centre, Beilinson Hospital, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Petah-Tiqva, Israel.
Clin Microbiol Infect. 2012 Jan;18(1):8-17. doi: 10.1111/j.1469-0691.2011.03613.x. Epub 2011 Aug 18.
In the late 1960s, the combination of trimethoprim and sulphamethoxazole (co-trimoxazole) was introduced into clinical practice and used to treat many infectious diseases, such as urinary tract infections, respiratory infections, sexually transmitted diseases, Gram-negative sepsis, enteric infections and typhoid fever. Subsequently, co-trimoxazole was reported to be effective against numerous bacterial, fungal and protozoal pathogens, including Nocardia, Listeria monocytogenes, Brucella, Stenotrophomonas maltophilia, Burkholderia, Coxiella burnetii, Tropheryma whipplei, atypical mycobacteria, and Pneumocystis jirovecii. Among protozoal infections, in addition to toxoplasmosis, co-trimoxazole has been used to treat susceptible Plasmodium falciparum, Cyclospora and Isospora infections. Several retrospective and prospective studies have demonstrated good clinical outcome with co-trimoxazole in treating invasive methicillin-resistant Staphylococcus aureus infections. We summarize herein the accumulated evidence in the literature on the new, 'unconventional' clinical use of co-trimoxazole during the last three decades. In the era of widespread antibiotic resistance and shortage of new antibiotic options, large-scale, well-designed studies are needed to explore the tremendous potential concealed in this well-established drug.
在 20 世纪 60 年代后期，将甲氧苄啶和磺胺甲恶唑（复方新诺明）组合引入临床实践，并用于治疗许多传染病，如尿路感染、呼吸道感染、性传播疾病、革兰氏阴性败血症、肠道感染和伤寒。随后，报道复方新诺明对许多细菌、真菌和原生动物病原体有效，包括诺卡氏菌、单核细胞增生李斯特菌、布氏杆菌、嗜麦芽窄食单胞菌、伯克霍尔德菌、科克斯氏体、惠利氏体、非典型分枝杆菌和肺孢子菌。在原生动物感染中，除了弓形体病，复方新诺明还用于治疗敏感的疟原虫、环孢子虫和隐孢子虫感染。几项回顾性和前瞻性研究表明，复方新诺明在治疗侵袭性耐甲氧西林金黄色葡萄球菌感染方面具有良好的临床疗效。我们在此总结了过去三十年文献中关于复方新诺明在新的、“非常规”临床应用方面的累积证据。在抗生素广泛耐药和新抗生素选择短缺的时代，需要进行大规模、精心设计的研究来探索这种广泛应用的药物所隐藏的巨大潜力。
