Trimethoprim-sulfamethoxazole recurrent

In women who experience symptomatic reinfections in association with sexual activity, voiding after intercourse may help prevent infection. Also, self-administered, single-dose prophylactic therapy with trimethoprim-sulfamethoxazole taken after intercourse has been found to significantly reduce the incidence of recurrent infection in these patients. 

Urinary tract infections (UTI) Recurrent infection Trimethoprim- sulfamethoxazole Excellent... 

SUveira C, Belfort R Jr, Muccioli C, et al.The effect of long-term intermittent trimethoprim/sulfamethoxazole on recurrences of toxoplasmic retinochoroiditis. Am J Ophthalmol 2002 134 41. 

Haas EJ. Trimethoprim-sulfamethoxazole another cause of recurrent meningitis. JAMA 1984 252(3) 346. 

Several other agents have been used to prevent recurrence of ANCA-associated diseases. Mycophenolate mofetU has been used anecdotally with favorable results for remission maintenance. Methotrexate has also been used however, it should not be given when the creatinine clearance is <50 mL/min. Trimethoprim-sulfamethoxazole was found to reduce ANCA-associated vasculitis, especially in the upper respiratory tract. 

Oral Therapy Sulfonamides Trimethoprim-sulfamethoxazole (TMP-SMX) These agents generally have been replaced by more agents due to resistance. This combination is highly effective against most aerobic enteric bacteria except Pseudomonas aeruginosa. High urinary tract tissue levels and urine levels are achieved, which may be important in complicated infection treatment. Also effective as prophylaxis for recurrent infections. 

Prophylaxis may be used to protect healthy persons from acquisition of or invasion by specific microorganisms to which they are exposed. Successful examples of this practice include rifampin administration to prevent meningococcal meningitis in close contacts of a known case, prevention of gonorrhea or syphUis after contact with an infected person, and the intermittent use of trimethoprim-sulfamethoxazole to prevent recurrent urinary tract infections. 

Treatment of uncomplicated lower urinary tract infections with trimethoprim—sulfamethoxazole often is highly effective for sensitive bacteria, usually for a minimum of 3 days. The combination is especially useful in chronic and recurrent infections of the urinary tract. Trimethoprim also is found in therapeutic concentrations in prostatic secretions, and trimethoprim—sulfamethoxazole is often effective for bacterial prostatitis. 

Chronic bacterial prostatitis occurs when acute bacterial prostatitis has been inadequately treated because of pathogen resistance, relapse, or short-course therapy or because of blocked drainage of secretions from the prostate. Most men with chronic prostatitis will have had a previous bout of acute prostatitis. The most common clinical feature of chronic prostatitis is recurrent urinary tract infections and the symptoms and complaints of acute bacterial prostatitis. Fluoroquinolones, trimethoprim-sulfamethoxazole, doxycycline, and nitrofurantoin are used in the management of chronic prostatitis. Chronic prostatitis warrants at least 10 to 12 weeks of therapy. Poor clinical outcomes, however, have been observed because of poor diffusion of antimicrobials into the prostate. 

In a randomized, open trial of long-term intermittent co-trimoxazole on recurrences of toxoplasmic retinochor-oiditis, four of 54 patients who took a single tablet of co-trimoxazole (trimethoprim 160 mg, sulfamethoxazole 800 mg) withdrew when they developed mild cutaneous erythema that resolved when drug treatment was stopped (129). 

Nanra RS, Anderton JL, Evans M, Fairley KF, Kincaid-Smith P. The use of trimethoprim and sulfamethoxazole in the management of chronic and recurrent upper and lower urinary tract infection. Med J Aust 1971 1 25-26. 

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