Use of intravenous co-trimoxazole to treat bacterial infection: analysis of 50 treatment episodes.

Co-trimoxazole is infrequently prescribed in the UK due to concerns regarding adverse events. However, it has a low association with Clostridium difficile-associated disease (CDAD) and may represent an alternative to higher-risk agents. This retrospective study examines the efficacy and safety of intravenous co-trimoxazole in treatment of bacterial infection in a UK inpatient population of 50 inpatients. Outcome was determined to be successful in 58% of treatment episodes; in hospital-acquired pneumonia the response rate was 52%. Two treatment episodes were terminated due to adverse events: these resolved on discontinuation of co-trimoxazole. No significant change in renal function, evaluated by serum creatinine, was observed during therapy; blood platelet count was not affected by treatment with intravenous co-trimoxazole. One patient developed CDAD within one month of cessation of therapy. Intravenous co-trimoxazole was clinically effective with a low rate of adverse events and may represent a useful alternative antimicrobial agent in UK institutions with high rates of CDAD.