Trimethoprim-sulfamethoxazole therapy for patients with carbapenemase-producing Klebsiella pneumoniae infections: retrospective single-center case series

Infection. 2017 Apr;45(2):209-213. doi: 10.1007/s15010-016-0968-x. Epub 2017 Feb 9.

Abstract

Objective: The objective of the study was to evaluate the efficacy and tolerability of trimethoprim-sulfamethoxazole (also known as co-trimoxazole, TMPS) to treat Klebsiella pneumoniae (Kp)-K. pneumoniae carbapenemase (KPC) infections.

Methods: Clinical data of patients with a TMPS-susceptible Kp-KPC infection were collected as a case series.

Results: We report clinical outcomes and tolerability for 14 patients infected by Kp-KPC strains susceptible to TMPS, including three bloodstream infections. In ten cases (71.4%), TMPS was administered as monotherapy. In all but one case, Kp-KPC infection was cured. In the remaining patient, therapy was discontinued because of an adverse event.

Conclusions: The use of TMPS to treat TMPS-susceptible Kp-KPC infections seems promising.

Keywords: Carbapenemase; Co-trimoxazole; KPC; Multidrug-resistant infections; Trimethoprim–sulfamethoxazole.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / metabolism*
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • beta-Lactamases
  • carbapenemase