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Author's response: co-trimoxazole treatment in idiopathic pulmonary fibrosis
  1. Ludmila Shulgina1,
  2. Anthony P Cahn2,
  3. Edwin R Chilvers3,
  4. Helen Parfrey3,
  5. Allan B Clark1,
  6. Edward C F Wilson1,
  7. Orion P Twentyman4,
  8. Anthony G Davison5,
  9. John J Curtin4,
  10. Michael B Crawford4,
  11. Andrew M Wilson1,4
  1. 1 Norwich Medical School, University of East Anglia, Norwich, UK
  2. 2 Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK
  3. 3 Respiratory Medicine Division, Department of Medicine, School of Clinical Medicine, University of Cambridge, Adenbrooke's/CUHNHSFT and Papworth Hospitals, Cambridge, UK
  4. 4 Department of Respiratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
  5. 5 Department of Respiratory Medicine, Southend University Hospital NHS Foundation Trust, Essex, UK
  1. Correspondence to Dr Andrew Wilson, Department of Medicine, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; a.m.wilson{at}

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We thank Neto et al 1 for their comments on our paper2 and for reiterating the points contained within it. ‘The survival benefit conferred by co-trimoxazole, if real, could be due to its antimicrobial activity as there was a significant reduction in the number of infections in the group receiving active treatment’, and this is likely to occur more frequently in patients receiving immunosuppressive treatment. The proportion of deaths in the intention-to-treat group on immunosuppression was 29 of 37. As stated, ‘this study was not designed to collect microbiological information’ however, the results were adjusted for baseline azathioprine or mycophenylate …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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