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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › SULFONAMIDES AND TRIMETHOPRIM › Combinations of sulfonamides and trimethoprim, incl. derivatives
sulfametrole and trimethoprim
J01EE03
Forms & Strengths
- Tablets: 100mg sulfametrole + 20mg trimethoprim
- Oral suspension: 50mg sulfametrole + 10mg trimethoprim per 5ml
- IV solution: 80mg sulfametrole + 16mg trimethoprim per 10ml ampoule
Adult Dosing
- UTI: 1 tablet (100mg sulfametrole + 20mg trimethoprim) every 12 hours for 10 days
- Acute exacerbations of chronic bronchitis: 1 tablet every 12 hours for 10 days
- Pneumocystis jirovecii pneumonia: 15-20mg/kg/day (trimethoprim component) IV in 3-4 divided doses for 14-21 days
Pediatric Dosing
- Children over 12 years: same as adult dose
- Children under 12 years: not recommended due to lack of data
Indications
- Urinary tract infections
- Acute exacerbations of chronic bronchitis
- Pneumocystis jirovecii pneumonia
- Prostatitis
Mechanism of Action
- Sulfametrole inhibits folic acid synthesis by competing with p-aminobenzoic acid
- Trimethoprim inhibits dihydrofolate reductase, further disrupting folic acid synthesis
- Synergistic effect leads to bactericidal activity against susceptible organisms
Contraindications
- Hypersensitivity to sulfonamides or trimethoprim
- Severe renal impairment (creatinine clearance < 15ml/min)
- Pregnancy at term and during breastfeeding
Adverse Reactions
- Gastrointestinal upset
- Allergic reactions (rash, fever, Steven-Johnson syndrome)
- Bone marrow suppression
- Renal impairment
Drug Interactions
- Potentiates oral anticoagulants
- Decreases the effectiveness of live vaccines
- Increases the risk of hyperkalemia with potassium-sparing diuretics
- Increases the risk of nephrotoxicity with cyclosporine
Curated Content: Needs Vetting Before Put to Clinical Use