Journal Article

Role of Folate Antagonists in the Treatment of Methicillin-Resistant Staphylococcus aureus Infection

Ellie J. C. Goldstein and Richard A. Proctor

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 4, pages 584-593
Published in print February 2008 | ISSN: 1058-4838
Published online February 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/525536
Role of Folate Antagonists in the Treatment of Methicillin-Resistant Staphylococcus aureus Infection

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Methicillin-resistant Staphylococcus aureus (MRSA) infection has reached epidemic proportions, and therapeutic options are limited because these strains are often multidrug resistant. However, the new strains of community-acquired MRSA show decreased resistance to trimethoprim-sulfamethoxazole. Clinical and experimental reports show a mixture of successes and failures with trimethoprim-sulfamethoxazole treatment. A reason for failure might be the amount of thymidine released from damaged host tissues and bacteria, a concept strengthened by the fact that S. aureus thermonuclease releases thymidine from DNA. Thus, success or failure with trimethoprim-sulfamethoxazole may well depend on the amount of tissue damage and organism burden, rather than acquisition of a resistance gene. Clinical trials and experimental animal studies show high failure rates, perhaps because of released thymidine. The use of trimethoprim-sulfamethoxazole for community-acquired MRSA infection should not be endorsed without further research.

Journal Article.  6353 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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