Trimethoprim-sulfamethoxazole (Bactrim, Septra, Cotrim)
By blocking tetrahydrofolic acid, selectively inhibits synthesis of nucleic acids and proteins by bacteria.
Dosage:
Adult
160 mg (trimethoprim)/800 mg (sulfamethoxazole) PO q12h (ie, one double-strength [DS] tab PO q12h)
Pediatric
<2 months: Do not administer
>2 months: 8-10 mg/kg/d (based on trimethoprim component) PO/IV divided q12h
Interactions:
May increase PT when used with warfarin (perform coagulation tests and adjust dose accordingly); coadministration with dapsone may increase blood levels of both drugs; coadministration of diuretics increases incidence of thrombocytopenia purpura in elderly patients; phenytoin levels may increase with coadministration; may potentiate effects of methotrexate in bone marrow depression; hypoglycemic response to sulfonylureas may increase with coadministration; may increase levels of zidovudine.
Contraindications:
Documented hypersensitivity; megaloblastic anemia due to folate deficiency; age <2>
Precautions:
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Do not use near term in pregnancy because of risk of kernicterus; discontinue at first appearance of skin rash or sign of adverse reaction; obtain CBC counts frequently; discontinue therapy if significant hematologic changes occur; goiter, diuresis, and hypoglycemia may occur with sulfonamides; prolonged IV infusions or high doses may cause bone marrow depression (if signs occur, administer 5-15 mg/d leucovorin); caution in folate deficiency (eg, people with long-term alcoholism, elderly people, those receiving anticonvulsant therapy, those with malabsorption syndrome); hemolysis may occur in individuals with G-6-PD deficiency; patients with AIDS may not tolerate or respond to therapy; caution in renal or hepatic impairment (perform urinalyses and renal function tests during therapy); administer fluids to prevent crystalluria and stone formation.
Read Users' Comments (1)comments
December 7, 2017 at 4:24 AM
Very useful info. Hope to see more posts soon!.
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