Spectrum: Local Antimicrobial Stewardship, for Lake of the Woods District Hospital

Trimethoprim-Sulfamethoxazole (Septra,TMP/SMX)

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

~$0.20 / day

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Hepatic

No dosage adjustments available. Use with caution. Contraindicated in cases of marked hepatic damage.

Adult

Renal

General Information

Common Usage

Common Usage

  •  Urinary tract infections

  •  Susceptible MRSA infections

  •  Stenotrophomonas infections

  •  Pneumocystis jirovecii pneumonia (Treatment or prophylaxis)

Drug Monitoring

Drug Monitoring

Follow creatinine and electrolytes in patients at increased risk renal failure, hyperkalemia.

Adverse Effects

Adverse Effects

  •  Gastrointestinal upset common

  •  Bone marrow suppression

  •  Hyperkalemia

  •  Renal failure

  •  Hepatitis

  •  Aseptic meningitis

  •  Stevens Johnson syndrome/toxic epidermal necrolysis

  •  Other rashes

Major Interactions

Major Interactions

  • ACEi - Increased serum potassium level

  • Increases amantadine levels

  • Decreases cyclosporine

  • Methotrexate - Marrow suppression

  • Increases phenytoin

  • Increases rifampin

  • Increases INR with warfarin

Pharmacology

Pharmacology

Antimicrobial class: Sulfonamide - Antifolate

Pregnancy category: C

Average serum half life: 10 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Moderate