Cotrimoxazole (TriSulfa-FPI) is a combination of trimethoprim and sulfamethoxazole in fixed amounts (trimethoprim 80 mg and sulfamethoxazole 400 mg) used to treat bacterial, fungal, and protozoal infections. It is developed and marketed worldwide under different brand names, including Septra (GlaxoSmithKline) and Bactrim (Hoffmann-La Roche). As a broad spectrum antibiotic, it also finds uses in other diseases where infections are secondary. Idiopathic pulmonary fibrosis (IPF) is one such disease where cotrimoxazole is being used as a therapeutic option.
History of Cotrimoxazole for IPF
Previous research has shown cotrimoxazole to be beneficial in small groups of patients with respiratory conditions which might or might not lead to IPF. However, it was uncertain as to how effectively the drug would act on people with IPF and other secondary infections, which worsen in the lungs in terms of inflammatory reactions. Some researchers believe that cotrimoxazole combined with a standard IPF medication could significantly improve a patient’s condition in terms of improving mortality and reducing clinical symptoms.
How Cotrimoxazole Fights IPF
Researchers believe that cotrimoxazole may help IPF patients by reducing or eradicating Pneumocystis jiroveci infection and colonization in the lungs, along with blocking activation of macrophages and inducing changes in the inner walls of the lungs and preventing inflammation and development of fibrosis. It is believed this novel approach could reduce morbidity and mortality in patients along with lowering treatment costs.
Next Steps for Cotrimoxazole
Currently, a Phase 3 clinical trial sponsored by the Fundación Pública Andaluza para la gestión de la Investigación en Sevilla (FISEVI) in Spain is underway to evaluate the effectiveness of the antibiotic in patients with IPF. The study began in June 2013 with 56 patients ages 18 to 80 with moderate IPF, and is expected to continue until August 2016. Final results are expected after completion.
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