Which medications in the drug class Antibiotics are used in the treatment of Granulomatosis with Polyangiitis (GPA, formerly Wegener Granulomatosis)?

Updated: Aug 31, 2021
  • Author: Christopher L Tracy, MD; Chief Editor: Herbert S Diamond, MD  more...
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Trimethoprim-sulfamethoxazole (TMP-SMZ) is recommended for prophylaxis against Pjiroveci pneumonia, typically as a daily dose, with single-strength dosing, or a dose of 3 times weekly with double-strength dosing. It is continued for as long as the patient is on immunosuppressive therapy. Data show that TMP-SMZ may be beneficial in decreasing relapses during maintenance therapy of GPA. Twice-daily dosing should not be combined with methotrexate, if possible, due to the risk of pancytopenia.

Additionally, in adults, TMP-SMZ has been shown to prevent relapses of GPA in remission. [18] This action of TMP-SMZ may be due to anti-inflammatory action or decrease in infections, particularly respiratory tract infections.

Trimethoprim-sulfamethoxazole (Septra DS, Bactrim, Bactrim DS)

TMP-SMZ inhibits the bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid, inhibiting folic acid synthesis. This results in the inhibition of bacterial growth. The antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa.

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