Effects of the antibiotics trimethoprim (TMP) and sulfamethoxazole (SMX) on granulation, microbiology, and performance of aerobic granular sludge systems.

This work assessed the effect of the antibiotics trimethoprim (TMP) and sulfamethoxazole (SMX) on the granulation process, microbiology, and organic matter and nutrient removal of an aerobic granular sludge (AGS) system. In addition, after the maturation stage, the impact of the redox mediator anthraquinone-2,6-disulfonate (AQDS) (25 µM) on the biotransformation of the antibiotics was evaluated. The reactor R1 was maintained as a control, and the reactor R2 was supplemented with TMP and SMX (200 µg L-1). The ability to remove C, N, and P was similar between the reactors. However, the structural integrity of the AGS was impaired by the antibiotics. Low TMP (∼30%) and SMX (∼60%) removals were achieved when compared to anaerobic or floccular biomass aerobic systems. However, when the system was supplemented with AQDS, an increase in the removal of TMP (∼75%) and SMX (∼95%) was observed, possibly due to the catalytic action of the redox mediator on cometabolic processes. Regarding the microbial groups, whereas Proteobacteria and Bacterioidetes increased, Planctomycetes decreased in both reactors. However, TMP and SMX presence seemed to inhibit or favor some genera during the formation of the granules, possibly due to their bactericidal action.

Efficacy and clinical tolerance of a new combination of trimethoprim with sulphonamide. A post-marketing and a literature survey.

To obtain a direct clinical evaluation of a new sulpha-trimethoprim combination product (Kelfiprim) from general practitioners or specialist practitioners, an extensive post-marketing survey has been organized in Brazil involving 1,177 doctors and 5,885 patients. These experienced different infections susceptible to oral antimicrobial chemotherapy with a sulpha-trimethoprim combination. The results indicated that the product was very effective (91.2% cure rate) and well tolerated (4% incidence of side-effects). Side-effects were usually mild and transient. No life-threatening adverse reactions were observed. The results obtained support those already published in clinical trials involving 1,119 patients.