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The sentence to which Dr. Goloff refers was intended to convey the meaning that the combination of trimethoprim and sulfamethoxazole is an effective and therefore primary medication for treating certain urinary tract infections. It was not meant to imply that this mixture is the best possible anti-infective for treating urinary tract infections or that it is necessarily a drug of choice for such purposes.It is important for every physician to have some general concept of the cost of each prescription he writes, especially if his patient possesses limited financial means. Certainly there are several good, less expensive regimens for treating urinary tract infections than the trimethoprim-sulfamethoxazole mixture. Nevertheless, if special conditions arise to indicate that this combination may be the drug of choice or if a strain of microorganism refractory to other conventional forms of medication is found to be sensitive to this mixture, the cost of
Schiffman DO. Trimethioprim-Sulfamethoxazole-Reply. JAMA. 1975;233(1):21. doi:10.1001/jama.1975.03260010023003