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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › SULFONAMIDES AND TRIMETHOPRIM › Short-acting sulfonamides
sulfafurazole
J01EB05
Adult Dosing
- Initial dose: 2 to 4 g orally
- Maintenance dose: 1 to 2 g orally every 4 to 6 hours
- Maximum dose: 8 g per day
Pediatric Dosing
- Children >2 months: Initial 75 mg/kg orally
- Maintenance: 150 mg/kg/day divided into 4 to 6 doses
- Maximum pediatric dose: 6 g per day
Indications
- Urinary tract infections primarily caused by susceptible E. coli, Klebsiella, and Enterobacter species
- Chlamydia trachomatis infections (alternative agent)
Mechanism of Action
- Competitively inhibits bacterial synthesis of dihydrofolic acid via dihydropteroate synthase blockade
- Bacteriostatic action preventing bacterial folic acid synthesis required for purine and pyrimidine production
Contraindications
- Hypersensitivity to sulfonamides
- Infants under 2 months of age due to risk of kernicterus
- Porphyria
- Severe hepatic impairment or marked hepatic damage
- Severe renal insufficiency when monitoring is not feasible
- Pregnancy at term and nursing mothers
Adverse Reactions
- Hypersensitivity reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, and rash
- Hematologic effects: agranulocytosis, aplastic anemia, hemolytic anemia in G6PD deficiency, thrombocytopenia
- Gastrointestinal: nausea, vomiting, anorexia, pancreatitis, hepatitis
- Renal: crystalluria, hematuria, toxic nephrosis
- Central nervous system: headache, peripheral neuritis, convulsions
Drug Interactions
- Potentiation of oral anticoagulants (e.g., warfarin) increasing bleeding risk
- Enhancement of hypoglycemic effects of sulfonylureas
- Increased myelosuppression and toxicity when combined with methotrexate
- Decreased sulfonamide efficacy when administered with para-aminobenzoic acid (PABA) derivatives
- Possible decreased clearance and increased toxicity of phenytoin
Curated Content: Needs Vetting Before Put to Clinical Use