Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial.

13 14 15 Resistance is described in Australia, where 30% of nosocomial and 10% of community associated MRSA isolates were resistant to trimethoprim-sulfamethoxazole in 2012, but a significant trend for decreasing resistance from 2005 was observed, unlike other antibiotics. 16 17 In sub-Saharan Africa, 19% resistance has been recently documented, owing to high rates of trimethoprim resistance. 18 In India, more than 85% of MRSA isolates were resistant to trimethoprim-sulfamethoxazole between 2009 and 2011. 19 20 Trimethoprim-sulfamethoxazole is recommended for the treatment of uncomplicated skin and soft tissue infections but not for MRSA bacteraemia or pneumonia. 21 Vancomycin is the primary treatment recommendation for these infections.

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