TRIMETHOPRIM-SULFAMETHOXAZOLE FOR THE PREVENTION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS PNEUMONIA IN SEVERELY BURNED PATIENTS

Background: Patients with severe burns are at increased risk of develo ping methicillin-resistant Staphylococcus aureus (MRSA) ventilator-ass ociated pneumonia. This study was designed to determine whether MRSA p neumonia can be prevented by prophylactic administration of trimethopr im-sulfamethoxazole (TMP-SMX). Methods: We conducted a prospective, ra ndomized, placebo-controlled study in patients with severe burns (grea ter than or equal to 20%), who required ventilator support. Prophylaxi s was done with oral TMP-SMX (80 mg/400 mg) three times daily for 10 d ays from 4 to 6 days after burn injury. The incidence of MRSA pneumoni a and the side effects were evaluated during the administration period .Results: Twenty-one patients were assigned to receive TMP-SMX, and 19 patients to receive placebo. The incidence of MRSA pneumonia was 4.8% in the TMP-SMX group and 36.8% in the placebo group, showing a signif icant difference (p = 0,017), No major side effects of therapy were se en in the TMP-SMX group. Conclusion: Prophylactic treatment with TMP-S MX can prevent MRSA pneumonia in severely burned patients.