Trimethoprim-Sulfamethoxazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

See Below

General Information

Common Usage

  •  Urinary tract infections

  •  MRSA infections

  •  Stenotrophomonas infections

  •  Pneumocystis jirovecii pneumonia (Treatment or prophylaxis)

  •   Toxoplasmosis prophylaxis

Cost Dollar

PO: <$1/day

PO susp: $5/day

IV: $70-90/day

Drug Monitoring

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

Adverse Effects

  •  Gastrointestinal upset common

  •  Bone marrow suppression

  •  Hyperkalemia

  •  Renal failure

  •  Hepatitis

  •  Aseptic meningitis

  •  Stevens Johnson syndrome/toxic epidermal necrolysis

  •  Other rashes

Major Interactions

ACEi - Increased serum potassium level

Methotrexate - Marrow suppression

Increases phenytoin

Increases INR with warfarin

Pharmacology

Antimicrobial class: Sulfonamide - Antifolate

Pregnancy category: D

Average serum half life: 10 hours

Biliary penetration: Moderate

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic