Trimethoprim-Sulfamethoxazole DS: Difference between revisions

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*Excretion:  
*Excretion:  
*Mechanism of Action: Bactericidal
*Mechanism of Action: Bactericidal
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||X22
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||X22
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||'''S'''
|-
| ||[[CA-MRSA]]||'''S'''
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||I
|-
| ||[[N. meningitidis]]||X2
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||I
|-
| ||[[E. coli]]||I
|-
| ||[[Klebsiella]] sp||I
|-
| ||E. coli/Klebsiella ESBL+||I
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||X1
|-
| ||[[Enterobacter]] sp, AmpC pos||X1
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||I
|-
| ||[[Salmonella]] sp||I
|-
| ||[[Shigella]] sp||I
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||I
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||'''S'''
|-
| ||[[Stenotrophomonas maltophilia]]||'''S'''
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||'''S'''
|-
| ||[[Brucella sp.]]||X2
|-
| ||[[Legionella sp.]]||'''S'''
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||I
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||X1
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||X1
|}
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==

Revision as of 04:59, 26 June 2014

General

  • Type: Sulfonamide
  • Dosage Forms: 160/800
  • Common Trade Names: Bactrim DS
  • Abbreviations: TMP-SMX, TMP-SMZ

Adult Dosing

General

1 tab (160mg TMP) PO Q12h

PCP Prophylaxis

80-160mg TMP PO daily

PCP Treatment

15-20 mg/kg/day TMP PO divided q6-8h x 21 days

Pediatric Dosing

General (>2mo)

  • Mild-mod infection
    • 4-5 mg/kg TMP PO q12hr
  • Severe infection
    • 15-20 mg/kg/dy TMP PO divided q6-8h

Special Populations

  • Pregnancy: D
  • Lactation: ?
  • Renal (Adult & Pediatric)
    • CrCl 15-30: Decrease dose by 50%
    • CrCl <15: Avoid use
    • Hemodialysis: Give supplement
    • Peritoneal Dialysis: No supplement
  • Hepatic (Adult & Pediatric)
    • Mild-mod impairment: Caution advised
    • Significant impairment: Contraindicated

Contraindications

  • Allergy to class/drug
  • <2 months of age (except as PCP prophylaxis)
  • Significant hepatic impairment
  • Megaloblastic anemia or folate deficiency
  • G6PD deficiency

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 6-12h (20-50h ESRD)
  • Metabolism:
  • Excretion:
  • Mechanism of Action: Bactericidal

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G X22
Strep. Pneumoniae S
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis X22
Enterococcus faecium R
MSSA S
MRSA S
CA-MRSA S
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis X2
Moraxella catarrhalis S
H. influenzae I
E. coli I
Klebsiella sp I
E. coli/Klebsiella ESBL+ I
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg X1
Enterobacter sp, AmpC pos X1
Serratia sp X1
Serratia marcescens I
Salmonella sp I
Shigella sp I
Proteus mirabilis X1
Proteus vulgaris R
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. I
Pseudomonas aeruginosa R
Burkholderia cepacia S
Stenotrophomonas maltophilia S
Yersinia enterocolitica S
Francisella tularensis S
Brucella sp. X2
Legionella sp. S
Pasteurella multocida X1
Haemophilus ducreyi I
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. X1

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

Source

  • Epocrates
  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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