biostudies-literatureWilson AMMedical Research CouncilNational Institute for Health Research (NIHR)2282-2291https://www.ebi.ac.uk/biostudies/studies/S-EPMC7724556biostudies-literatureUnknown324(22)<h4>Importance</h4>Idiopathic pulmonary fibrosis (IPF) has a poor prognosis and limited treatment options. Patients with IPF have altered lung microbiota, with bacterial burden within the lungs associated with mortality; previous studies have suggested benefit with co-trimoxazole (trimethoprim-sulfamethoxazole).<h4>Objective</h4>To determine the efficacy of co-trimoxazole in patients with moderate and severe IPF.<h4>Design, setting, and participants</h4>Double-blind, placebo-controlled, parallel randomized trial of 342 patients with IPF, breathlessness (Medical Research Council dyspnea scale score >1), and impaired lung function (forced vital capacity ≤75% predicted) conducted in 39 UK specialist interstitial lung disease centers between April 2015 (first patient visit) and April 2019 (lasJAMAEffect of Co-trimoxazole (Trimethoprim-Sulfamethoxazole) vs Placebo on Death, Lung Transplant, or Hospital Admission in Patients With Moderate and Severe Idiopathic Pulmonary Fibrosis: The EME-TIPAC Randomized Clinical Trial.PMC7724556MC_PC_14145CS-2013-13-017Chilvers ERFraser WCahn TSwart AMStirling SMaher TMHammond MWhyte MEME-TIPAC teamThickett DRParfrey HClark ABWilson AMLivermore DMfalseEffect of Co-trimoxazole (Trimethoprim-Sulfamethoxazole) vs Placebo on Death, Lung Transplant, or Hospital Admission in Patients With Moderate and Severe Idiopathic Pulmonary Fibrosis: The EME-TIPAC Randomized Clinical Trial.<h4>Importance</h4>Idiopathic pulmonary fibrosis (IPF) has a poor prognosis and limited treatment options. Patients with IPF have altered lung microbiota, with bacterial burden within the lungs associated with mortality; previous studies have suggested benefit with co-trimoxazole (trimethoprim-sulfamethoxazole).<h4>Objective</h4>To determine the efficacy of co-trimoxazole in patients with moderate and severe IPF.<h4>Design, setting, and participants</h4>Double-blind, placebo-controlled, parallel randomized trial of 342 patients with IPF, breathlessness (Medical Research Council dyspnea scale score >1), and impaired lung function (forced vital capacity ≤75% predicted) conducted in 39 UK specialist interstitial lung disease centers between April 2015 (first patient visit) and April 2019 (las2020-01-01T00:00:00Z2020 Dec2025-05-31T22:20:36.637Z2025-05-31T22:20:36.637ZS-EPMC77245563328982210.1001/jama.2020.22960