Pneumonia in an Immunocompromised Host:
Cutaneous Abscesses, Furuncles, Carbuncles, and Boils (with or without cellulitis):
If there are risk factors for MRSA or failed 1st-line outpatient treatment despite adequate adherence:
Use Clindamycin or Doxycycline if Group A strep is strongly suspected despite failure of 1st-line treatment
TMP-SMX does not cover Streptococcal infections well
ODB covered (tablet)
Stevens Johnson syndrome/toxic epidermal necrolysis, other rashes, gastrointestinal upset is common, bone marrow suppression, hyperkalemia, renal failure, hepatitis, aseptic meningitis
CBC, renal function test, liver function test, urinalysis; observe for change in bowel frequency
Sulfa antibiotics have been shown to displace bilirubin from protein binding sites which may potentially lead to hyperbilirubinemia and kernicterus in neonates and young infants; do not use in neonates; avoid use in infants <2 months unless other options are not available (eg, Pneumocystis)
May be taken with or without food
Maintain fluid intake. May be given with food
Do not give to infants <1 month old due to risk of kernicterus
Special Access Program authorization required for suspension, which is no longer marketed in Canada
Brand names: Cotrimoxazole, Septra, Bactrim
Trimethoprim and Sulfamethoxazole (TMP/SMX) is available in combination as a fixed dose ratio of 1:5