%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Ameen, S. M.
%A Rolain, J. M.
%A Le Poullain, M. N.
%A Roux, V.
%A Raoult, Didier
%A Drancourt, M.
%T Serum concentration of co-trimoxazole during a high-dosage regimen
%D 2014
%L PAR00011502
%G ENG
%J Journal of Antimicrobial Chemotherapy
%@ 0305-7453
%K sulfamethoxazole ; trimethoprim ; MRSA
%M ISI:000331827200027
%N 3
%P 757-760
%R 10.1093/jac/dkt400
%U https://www.documentation.ird.fr/hor/PAR00011502
%V 69
%W Horizon (IRD)
%X Objectives: Sulfamethoxazole and trimethoprim have been used for decades, yet high dosages are rarely reported. We aimed to measure blood concentrations of both molecules in this situation. Methods: Between 2002 and 2010, 22 patients received two tablets of co-trimoxazole three times a day, equivalent to a daily dosage of 2400 mg of sulfamethoxazole and 480 mg of trimethoprim. The trimethoprim and sulfamethoxazole concentrations were determined 3 h after administration using ion-paired HPLC. Results: In the presence of a negative control, which yielded no peaks at the retention times for trimethoprim and sulfamethoxazole, the mean +/- SD value for sulfamethoxazole concentration was 161.01 +/- 69.154 mg/L and the mean +/- SD value for trimethoprim was 5.788 +/- 2.74 mg/L. Conclusions: These concentrations are largely above the trimethoprim and sulfamethoxazole MIC distributions as well as the trimethoprim resistance clinical breakpoint (4 mg/L) reported by EUCAST in 2012 for most bacterial pathogens, including Gram-positive species such as Staphylococcus aureus. Our results support proposing a high-dosage regimen of co-trimoxazole as a suitable alternative for methicillin-resistant S. aureus infections.
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