Trimethoprim-Sulfamethoxazole

C difficile risk
Low
Oral Bioavailability
Excellent

Dosing

  • SSTI, UTI: 1-2 DS tabs PO BID

  • PJP Tx, Resp Stenotrophomonas: 15-20mg/kg/day of TMP IV/PO divided q8-6h

CrCl 0 - 10CrCl 10 - 30CrCl > 30- SSTI, UTI: Not routinely recommended. Consider 1 SS or 1 DS tablet Q24h.

  • PJP Tx, Resp Stenotrophomonas: 5 mh/kg of TMP q24h -or – 2DS Tabs q24h - SSTI, UTI: 1 – 2 DS Tabs Q24h

  • PJP Tx, Resp Stenotrophomonas: 15-20mg/kg/day of TMP IV/PO divided q8-6h x 48hr, then 50% of total daily dose divided q12h.Usual dosing

  • SSTI, UTI: Not recommended

  • PJP Tx, Resp Stenotrophomonas: 5 mh/kg of TMP q24h -or – 1 SS or DS Tab q24h

2.5-10mg/kg of TMP IV q12h depending on indication

General Information

  •  Urinary tract infections

  •  Susceptible MRSA infections

  •  Stenotrophomonas infections

  •  Pneumocystis jirovecii pneumonia (Treatment or prophylaxis)

Monitor SCr, Sodium and Potassium, particularly in patients at increased risk of renal failure.

  •  Gastrointestinal upset common

  •  Bone marrow suppression

  •  Hyperkalemia

  •  Renal failure

  •  Hepatitis

  •  Aseptic meningitis

  •  Stevens Johnson syndrome/toxic epidermal necrolysis

  •  Other rashes

Increases INR with warfarin

ACEi /ARB - Increased serum potassium level

Increases: amantadine levels, phenytoin, rifampin

Decreases cyclosporine

Methotrexate - Marrow suppression

Antimicrobial class: Sulfonamide - Antifolate

Pregnancy category: C

Average serum half life: 10 hours

Biliary penetration: Moderate

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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