Three cases of Wegener's granulomatosis treated with an antimicrobial agent.

Sulfamethoxazole-trimethoprim, an antimicrobial agent, was used to treat three cases of cytotoxic agent-resistant Wegener's granulomatosis; one case was refractory to a regimen consisting of azathioprine and prednisolone, and in another two cases the therapy was insufficient to control the disease. By the introduction of sulfamethoxazole-trimethoprim, which has an advantage of fewer side effects compared with the conventional agents, into the regimen, the disease condition was markedly improved in all cases within four months. Sulfamethoxazole-trimethoprim is thus considered as one of the most promising drugs to treat, especially, cytotoxic agent-resistant Wegener's granulomatosis. The possible underlying mechanism of the effect of sulfamethoxazole-trimethoprim is also described.