trimethoprim--sulfamethoxazole-drug-combination and Skin-Diseases

Over the last year there has been major publications related to therapeutic trials in infectious dermatology, not only with regard to Herpes zoster subunit vaccine but also for the treatment of uncomplicated abscesses or scabies. In addition, biological treatments continue to be on the forefront, not only in the treatment of psoriasis but also in other chronic inflammatory dermatologic diseases such as atopic dermatitis and hidradenitis suppurativa, two diseases that significantly impact quality of life and for which there are to date, few therapeutic alternatives in moderate to severe forms. In addition, the treatment of cyclin-resistant papulopustular rosacea was also the subject of a large French controlled randomized controlled trial that could modify our therapeutic approach by the use of isotretinoin. Finally, the prevention of rashes induced by erlotinib with oral doxycyline is also part of this 2016 "what's new in dermatological therapeutics".

Topics: Adalimumab; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Dermatologic Agents; Dermatology; Erlotinib Hydrochloride; Herpes Zoster Vaccine; Humans; Interleukin 1 Receptor Antagonist Protein; Isotretinoin; Piperidines; Protein Kinase Inhibitors; Pyrimidines; Pyrroles; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

A short cut review was carried out to establish whether incision and drainage followed by treatment with oral trimethoprim-sulfamethoxazole is better than incision and drainage alone at treating patients with uncomplicated skin abscesses. One hundred and ninety-seven papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that trimethoprim-sulfamethoxazole may help with abscess cure, and will decrease abscess formation at new sites.

Topics: Abscess; Anti-Bacterial Agents; Evidence-Based Emergency Medicine; Humans; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acetylation; Adolescent; Chemical and Drug Induced Liver Injury; Cytotoxicity Tests, Immunologic; Hematologic Diseases; Humans; Kidney Diseases; Liver Diseases; Lymphocytes; Male; Phenotype; Skin Diseases; Thyroid Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Whipple's disease is a systemic bacterial infection that once was uniformly fatal and now is treatable with several different antibiotics in most cases. The exact nature of the Whipple's bacillus is unknown, since the organism cannot consistently be cultured. There is also controversy concerning the role of immunologic dysfunction in patients with Whipple's disease. In addition to the small intestine, Whipple's disease can involve the remainder of the gastrointestinal tract, as well as the lymph nodes, joints, nervous system, heart, eyes, hematopoietic system, lungs, liver, and other organs. The clinical manifestations, diagnosis, and treatment of this rare but fascinating disease will be reviewed in this article.

Topics: Bacterial Infections; Diagnosis, Differential; Drug Combinations; Eye Diseases; Heart Diseases; Hematologic Diseases; Humans; Joint Diseases; Lung Diseases; Lymphatic Diseases; Muscular Diseases; Nervous System Diseases; Penicillins; Skin Diseases; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Whipple Disease

The objective was to determine whether the routine packing of simple cutaneous abscesses after incision and drainage (I&D) confers any benefit over I&D alone.. In a prospective, randomized, single-blinded trial, subjects with simple cutaneous abscesses (less than 5 cm largest diameter) underwent incision, drainage, irrigation, and standard abscess preparation in the usual manner. Subjects were then randomized to either packing or no-packing. Visual analog scales (VAS; 100 mm) of pain were recorded in the emergency department (ED). All patients received trimethoprim-sulfamethoxazole (TMP-SMX), ibuprofen, and narcotic prescriptions, recorded twice daily VAS pain scores, and returned in 48 hours at which time dressings and packing, if present, were removed and a physician blinded to the randomization and not part of the initial visit repeated measurements and determined the need for further intervention.. Forty-eight subjects were included in the final analysis. There were no significant differences in age, sex, abscess location, or initial pain scores between the two groups. There was no significant difference in need for a second intervention at the 48-hour follow-up between the packed (4 of 23 subjects) and nonpacked (5 of 25 subjects) groups (p = 0.72; relative risk = 1.3, 95% confidence interval [CI] = 0.4 to 4.2). Patients in the group that received packing reported higher pain scores immediately postprocedure (mean difference = 23.8 mm; p = 0.014, 95% CI = 5 to 42 mm) and at 48 hours postprocedure (mean difference = 16.4 mm; p = 0.03, 95% CI = 1.6 to 31.2 mm), as well as greater use of ibuprofen (mean difference = 0.32; p = 0.12, 95% CI = -1.4 to 2.0) and oxycodone/acetaminophen (mean difference = 2.19; p = 0.03, 95% CI = 0.2 to 4.1).. In this pilot study, not packing simple cutaneous abscesses did not result in any increased morbidity, and patients reported less pain and used fewer pain medications than packed patients.

Topics: Abscess; Analgesics, Non-Narcotic; Anti-Infective Agents; Drainage; Emergency Service, Hospital; Female; Humans; Ibuprofen; Male; Narcotics; Pain Measurement; Pain, Postoperative; Prospective Studies; Single-Blind Method; Skin Diseases; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Dapsone; Humans; Pneumonia, Pneumocystis; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Abscess; Anti-Bacterial Agents; Drainage; Humans; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Anti-Infective Agents; Bacterial Infections; Humans; Male; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Yersinia Infections; Yersinia pseudotuberculosis

Topics: Anti-Infective Agents; Brain Abscess; Graft Rejection; Humans; Kidney Transplantation; Male; Middle Aged; Nocardia Infections; Pneumonia, Bacterial; Skin Diseases; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination

Anaphylactic reactions to cotrimoxazole are often ascribed to the sulphamethoxazole component of this antibacterial drug.. To determine whether the trimethoprim component can be the cause of an anaphylactic reaction.. An analysis was made of reports on anaphylaxis attributed to trimethoprim, as notified to the Drug Safety Unit of the Dutch Inspectorate for Health Care.. In the period between September 1981 and November 1995, 13 such reports were received. Nine were classified as probable anaphylaxis. Of these, the causal relationship between exposure to trimethoprim and anaphylaxis was classified as definite in three reports, and as probable in the other six. The remaining four reports were classified as possible anaphylaxis. In one of these, the causal relationship was classified as definite, and in three as probable.. Although anaphylaxis due to trimethoprim seems to be rare, it may be more common than previously thought. Apparently, anaphylaxis to cotrimoxazole is not always caused by sulphamethoxazole.

Topics: Adult; Aged; Anaphylaxis; Anti-Infective Agents, Urinary; Antibodies, Anti-Idiotypic; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Respiratory Tract Diseases; Skin Diseases; Time Factors; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The objective of this study was to quantify the risk of serious blood and skin disorders associated with co-trimoxazole.. We conducted a population-based cohort study of serious blood and skin disorders requiring hospitalization among otherwise healthy users of co-trimoxazole at Group Health Cooperative and Puget Sound (GHC).. During the years 1987 to 1993 we found six cases of co-trimoxazole-associated blood disorders and three cases of co-trimoxazole-associated skin disorders yielding risks of 5.6/100,000 (95% CI 2.6-12.2) and 2.8/100,000 (95% CI 0.9-8.2) respectively. In all cases found there was prompt recovery after discontinuation of co-trimoxazole. We found no cases of toxic epidermal necrolysis.. We conclude that the risk of blood and skin disorders associated with the use of co-trimoxazole leading to hospitalization is low.

Topics: Adult; Aged; Anti-Infective Agents; Child, Preschool; Cohort Studies; Erythema Multiforme; Female; Hematologic Diseases; Hospitalization; Humans; Leukopenia; Longitudinal Studies; Male; Middle Aged; Neutropenia; Pancytopenia; Risk Assessment; Skin Diseases; Stevens-Johnson Syndrome; Thrombocytopenia; Trimethoprim, Sulfamethoxazole Drug Combination

To quantify the risk of serious blood and skin disorders requiring hospitalization among otherwise healthy users of co-trimoxazole.. We conducted a population-based cohort study at Group Health Cooperative of Puget Sound (GHC).. During the years 1987 to 1993 we found six cases of co-trimoxazole-associated blood disorders and three cases of co-trimoxazole-associated skin disorders yielding risks of 5.6/100,000 (95% CI 2.6-12.2) and 2.8/100,000 (95% CI 0.9-8.2) respectively. In all cases found there was prompt recovery after discontinuation of co-trimoxazole. We found no cases of toxic epidermal necrolysis.. We conclude that the risk of blood and skin disorders associated with the use of co-trimoxazole leading to hospitalization is low.

Topics: Adult; Aged; Anti-Infective Agents; Child, Preschool; Cohort Studies; Erythema Multiforme; Female; Hematologic Diseases; Hospitalization; Humans; Leukopenia; Longitudinal Studies; Male; Middle Aged; Neutropenia; Pancytopenia; Product Surveillance, Postmarketing; Risk Assessment; Skin Diseases; Stevens-Johnson Syndrome; Thrombocytopenia; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Cephalexin; Chemical and Drug Induced Liver Injury; Follow-Up Studies; Hematologic Diseases; Humans; Kidney Diseases; Skin Diseases; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Nocardiosis is a rare localized or systemic infection caused by bacteria of the Actinomycetaceae family. Nocardia farcinica, recently identified as a distinct species from Nocardia asteroides, characteristically causes severe systemic infections and is particularly resistant to antibiotics. We report a case of nocardiosis observed in a patient receiving general corticosteroid therapy for bullous pemphigoid and who developed a sub-cutaneous abscess of the breast. N. farcinica was identified on puncture specimens and found to be resistant to beta-lactams, aminosides, cyclines, chloramphenicol, fosfomycin and pefloxacin. No dissemination beyond the skin was observed. The abscess was drained and cleaned surgically and cicatrization was uneventful. Six weeks later the patient was again hospitalized for an inflammatory abscess of the left buttocks which was drained surgically. N. farcinica was again identified and a complete work-up eliminated dissemination. Cotrimoxazole was given as a long-term therapy (480 mg trimethoprim, 2.4g sulfamethoxazole) for 6 months and was well tolerated. No recurrence was observed.

Topics: Abscess; Aged; Aged, 80 and over; Female; Humans; Immune Tolerance; Nocardia; Nocardia Infections; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Clofazimine; Female; Humans; Malacoplakia; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Child, Preschool; Clofazimine; Consanguinity; Drug Therapy, Combination; Ethambutol; Female; Hepatomegaly; Humans; Immunity, Cellular; Joint Diseases; Mycobacterium Infections; Rifampin; Skin Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Breast Neoplasms; Drug Combinations; Female; Humans; Middle Aged; Radiodermatitis; Radiotherapy; Skin Diseases; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Drug Combinations; Female; Humans; Male; Middle Aged; Skin Diseases; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adult; Aged; Bacterial Infections; Drug Combinations; Female; Humans; Male; Middle Aged; Skin Diseases; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination