Antimicrobials
Sulfamethoxazole-Trimethoprim

Sulfamethoxazole-Trimethoprim

Medium
Excellent (90 to 100%)
IV$$$ PO$

Dosing

General Information

  • Urinary tract infections
  • MRSA infections
  • Stenotrophomonas infections
  • Pneumocystis jirovecii pneumonia (treatment or prophylaxis)
  • Follow creatinine and electrolytes in patients at increased risk renal failure
  • Hyperkalemia
  • CBC for cytopenias
  • Stevens Johnson syndrome/toxic epidermal necrolysis
  • Other rashes
  • Gastrointestinal upset common
  • Bone marrow suppression
  • Hyperkalemia
  • Renal failure
  • Hepatitis
  • Aseptic meningitis
  • ACEi - increased serum potassium level
  • Methotrexate - marrow suppression
  • Increases phenytoin
  • Increases INR with warfarin

Prisma Health Inpatient Formulary
Suspension: 200 mg/5 mL

Prisma Health Inpatient Formulary
Tablet: 400 mg, 800 mg

  • Regular strength tablets 400mg SMX/80 mg TMP
  • Double strength tablets 800 mg SMX/160mg TMP

Antimicrobial class: Sulfonamide - Antifolate

Average serum half life:

  • TMP (prolonged in renal failure)
    • Newborns: ~19 hours; range: 11-27 hours
    • Infants 2 months to 1 year: ~4.6 hours; range: 3-6 hours
    • Children 1-10 years: 3.7-5.5 hours
    • Children and Adolescents >10 years: 8.19 hours
    • Adults: 6-11 hours
  • SMX: 9-12 hours, prolonged in renal failure (Adult data)

Route of Elimination: Both excreted in urine as metabolites and unchanged drug