Trimethoprim/Sulfamethoxazole

C difficile risk
Low
Oral Bioavailability
Excellent
Cost
IV:$$$ PO:¢

Dosing

CrCl ≥30 mL/minCrCl 10-29 mL/minCrCl <10 mL/min8-20 mg/kg IV divided into Q6-12h4-10 mg/kg IV divided Q6-12hDo not use

2.5-10 mg/kg IV Q24h, or 5-20 mg/kg IV TIW (doses given on HD days should be given after HD)

2.25-7.5 mg/kg IV Q12h

PO: 1-2 DS tabs PO BID

IV: 15-20mg/kg/day of TMP IV in 4 divided doses

General Information

  • Urinary tract infections

  • Susceptible MRSA infections

  • Stenotrophomonas infections

  • Pneumocystis jirovecii pneumonia (Treatment or prophylaxis)

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

  • Gastrointestinal upset common

  • Bone marrow suppression

  • Hyperkalemia

  • Renal failure

  • Hepatitis

  • Aseptic meningitis

  • Stevens Johnson syndrome/toxic epidermal necrolysis

  • Other rashes

  • ACEi - Increased serum potassium level

  • Increases amantadine levels

  • Decreases cyclosporine

  • Methotrexate - Marrow suppression

  • Increases phenytoin

  • Increases rifampin

  • Increases INR with warfarin

Antimicrobial class: Sulfonamide - Antifolate

Pregnancy category: C

Average serum half life: 10 hours

Biliary penetration: Moderate

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic