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Sulfonamides without trimethoprim in the treatment of Nocardia infections: A case report and literature review
Author(s) -
Root Heather,
Daniels Lindsay,
Marx Ashley,
Bartelt Luther A.,
Lachiewicz Anne M.,
Duin David
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13452
Subject(s) - sulfadiazine , medicine , nocardia , trimethoprim , sulfamethoxazole , sulfonamide , nocardia infections , antibiotics , nocardiosis , silver sulfadiazine , dermatology , microbiology and biotechnology , surgery , bacteria , biology , chemistry , genetics , wound healing , stereochemistry
Abstract Sulfonamides are recommended as part of first‐line therapy for most Nocardia infections, with trimethoprim‐sulfamethoxazole (TMP‐SMX) considered the drug of choice for susceptible isolates. However, in the case of central nervous system, disseminated disease, and other serious Nocardia infections, TMP‐SMX should not be used as monotherapy. The preferred treatment for a patient unable to take TMP‐SMX because of allergy or intolerance remains uncertain. Prior to the availability of TMP‐SMX in 1973, other sulfonamides were mainstays of treatment. We describe a Nocardia infection successfully treated with sulfadiazine in a lung transplant recipient who could not tolerate TMP‐SMX. A review of similar cases reported in the literature provides insight into the successful treatment of Nocardia infections with sulfonamide regimens not containing trimethoprim in transplant recipients and other immunocompromised hosts.