Spectrum: Local Antimicrobial Stewardship, for Island Health

Trimethoprim-Sulfamethoxazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

IV$100/d PO$1/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Adult

PO: 1-2 DS tabs PO BID
IV: 15-20mg/kg/day of TMP IV in 4 divided doses

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: 10.0

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Biliary penetration: Moderate