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Correspondence
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Volume 357:2090 November 15, 2007 Number 20
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Methicillin-Resistant Staphylococcus aureus Infections

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by Daum, R. S.
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To the Editor: In his review of skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA), Daum (July 26 issue)1 cites a study2 indicating that intravenous trimethoprim–sulfamethoxazole (TMP-SMX) is significantly less effective than vancomycin for the treatment of serious S. aureus infections. However, in this randomized, double-blind, comparative trial of TMP-SMX and vancomycin, therapeutic failures occurred only in patients with methicillin-susceptible S. aureus (MSSA) infections. TMP-SMX was successful in treating all MRSA infections, including tricuspid-valve endocarditis. Clinical failures commonly occurred with MSSA tricuspid-valve endocarditis; otherwise, the cure rates with TMP-SMX and with vancomycin were similar. On the basis of . . . [Full Text of this Article]



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