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Randomised controlled trial
Trimethoprim-sulfamethoxazole monotherapy should not be used for treatment of severe methicillin-resistant Staphylococcus aureus infections
  1. Stephan Harbarth
  1. Infection Control Program, Geneva University Hospitals and Medical School, Geneva, Switzerland
  1. Correspondence to : Professor Stephan Harbarth, Infection Control Program, Geneva University Hospitals and Medical School, Geneva 14 CH-1211, Switzerland; stephan.harbarth{at}

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Despite decreasing incidence in many countries, severe infections caused by methicillin-resistant Staphylococcus aureus (S aureus, MRSA) continue to pose therapeutic challenges. Most MRSA strains remain susceptible to older antimicrobial agents such as trimethoprim-sulfamethoxazole (TMP-SMX);1 however, few randomised trials have evaluated its efficacy compared to current standard treatment options (vancomycin, daptomycin, linezolid).2 ,3 A single randomised controlled trial conducted more than two decades ago suggested that TMP-SMX may be a useful alternative to vancomycin for treatment of severe S aureus infections.4 This clinical trial examined whether TMP-SMX is non-inferior compared with vancomycin, for the treatment of …

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  • Competing interests SH has received peer-reviewed research grants funded by Pfizer and B Braun, and is a member of the advisory boards of Destiny Pharma, bioMérieux, Novartis and DaVolterra.

  • Patient consent Obtained.

  • Provenance and peer review Commissioned; internally peer reviewed.