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ALIMENTARY TRACT AND METABOLISM › ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS › INTESTINAL ANTIINFECTIVES › Sulfonamides
sulfaguanidine
A07AB03
Adult Dosing
- Acute bacillary dysentery: 3 to 4 g every 4 to 8 hours for initial treatment, followed by maintenance doses of 3 to 4 g every 8 hours for several days.
- Bowel sterilization prior to surgery: 3 to 6 g daily in divided doses.
Pediatric Dosing
- Children (> 2 months): 0.1 to 0.2 g/kg body weight every 4 to 8 hours, adjusted based on clinical response and tolerability.
Indications
- Treatment of bacillary dysentery
- Enteritis and other enteric bacterial infections
- Pre-operative suppression of gut flora
Mechanism of Action
- Poorly absorbed sulfonamide acting primarily locally within the gastrointestinal lumen
- Competitively inhibits bacterial synthesis of dihydrofolic acid via dihydropteroate synthase inhibition, reducing bacterial proliferation in the gut
Contraindications
- Known hypersensitivity to sulfonamides
- Infants under 2 months of age (risk of kernicterus)
- Severe hepatic impairment
- Severe renal impairment
- Intestinal obstruction
Adverse Reactions
- Nausea and vomiting
- Abdominal discomfort or diarrhea
- Hypersensitivity reactions (skin rash, pruritus, urticaria)
- Rare hematological abnormalities (leukopenia, thrombocytopenia) due to minimal systemic absorption
Drug Interactions
- Oral anticoagulants (may enhance effects of coumarin anticoagulants)
- Local anesthetics derived from PABA (may antagonize antibacterial activity of sulfonamides)
- Methenamine (may form an insoluble precipitate in the urine)
Curated Content: Needs Vetting Before Put to Clinical Use