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Pittsburgh manager Clint Hurdle said Karstens never found his rhythm.
"For whatever reason, he wasn't as sharp as he's been," Hurdle said. "It just wasn't there for him today."
The Cardinals scored three runs in the first to take a 3-1 lead. Five of the first seven hitters reached base.
Pittsburgh answered with three runs in the second to go up 4-3. Ronny Cedeno had a run-scoring single, and Josh Harrison and Michael McKenry added doubles.
Theriot's RBI single tied it in the third, and Lohse scored in the fourth.
David Freese brought in Holliday with a run-scoring single in the seventh to push the lead to 6-4.
"This was one of our better wins," La Russa said. "A tough start, but we hung in there."
NOTES: On July 26, the Cardinals were in first place by a half-game. They have gone 15-16 since. ... Harrison is 11 for 27 in his last eight games. ... St. Louis starters gave up at least three runs in one inning in all four games of the series. ... The Pirates are 31-34 on the road after a league-worst 17-64 last season. ... The Pirates open a three-game series at Houston on Monday. Ross Ohlendorf (0-1, 7.24) will face Houston lefty Wandy Rodriguez (9-9, 3.41). ... The Cardinals travel to Milwaukee to start a three-game set Tuesday.
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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