Potential role of trimethoprim-sulfamethoxazole in the treatment of serious hospital-acquired bacterial infections.

Although trimethoprim-sulfamethoxazole (TMP-SMZ) has become a standard agent for the treatment of a broad range of infections, it may often be overlooked as a choice for treatment of serious hospital-acquired infections. A review of the literature shows that a number of common and uncommon gram-negative and gram-positive organisms susceptible to TMP-SMZ are frequently resistant to cephalosporins. TMP-SMZ has, in addition to its exceptional microbiologic activity, pharmacokinetic characteristics that make it a potentially cost-effective alternative to third-generation cephalosporins in the treatment of serious hospital-acquired infections caused by susceptible organisms.