COTRIMOXAZOLE
(Septra, TMP-SMX, Novo-Trimel, Apo-Sulfatrim)Standard Prescription
Cotrimoxazole __mg TMP/__mg SMX IV{PO} Q__H (__TMP/__SMX/kg/24hr)
Dosages
Mild to Moderate Infections:
4-6 mg TMP/20-30 mg SMX/kg/dose PO/IV Q12H (for PO dosing: 0.5-0.75 mL/kg/dose PO Q12H).
Severe Infections:
320 mg TMP/1600 mg SMX/dose PO Q6-8H
4-6 mg TMP/20-30 mg SMX/kg/dose PO/IV Q12H (for PO dosing: 0.5-0.75 mL/kg/dose PO Q12H).
Severe Infections (pneumocystis jiroveci):
5 mg TMP/25 mg SMX/kg/dose PO/IV Q6H x 21 days.Cystic Fibrosis:
6 mg TMP/30 mg SMX/kg/dose PO Q12H. May increase to 5 mg TMP/25 mg SMX/kg/dose PO/IV Q6H for severe infections. PO Max 320 mg TMP/doseProphylaxis of Pneumocystis jiroveci in Immunocompromised Patients (non-HIV):
2.5 mg TMP/12.5 mg SMX/kg/dose PO Q12H on 2 consecutive days per week (approximately 0.3 mL/kg/dose).
Prophylaxis for U.T.I.:
2 mg- TMP/10 mg SMX/kg/dose PO once daily (i.e. 0.25-mL/kg/dose).Adult Max:
Mild to Moderate Infections:160 mg TMP/800 mg SMX/dose PO Q12H
320 mg TMP/1600 mg SMX/dose PO Q6-8H
Mechanism of Action
Sulfonamide antibiotic; combination of trimethoprim and sulfamethoxazole in 1:5 ratio
Forms Supplied
tablet: trimethoprim 80 mg/ sulfamethoxazole 400 mg
(DS tablets: TMP 160 mg/SMX 800 mg are available but not stocked at BCCH)
oral suspension: trimethoprim 8 mg/ sulfamethoxazole 40 mg per mL
injection: trimethoprim 16 mg/ sulfamethoxazole 80 mg per mL
Comments
Bioavailability 90-100%.
Use IV form only when PO form cannot be administered.
10 mL oral liquid = 1 tablet.
TMP = trimethoprim.
SMX = sulfamethoxazole.
Not recommended for children <1 month old
Monitor for neutropenia and elevated liver enzymes with higher doses and longer treatment duration.
Use IV form only when PO form cannot be administered.
10 mL oral liquid = 1 tablet.
TMP = trimethoprim.
SMX = sulfamethoxazole.
Not recommended for children <1 month old
Monitor for neutropenia and elevated liver enzymes with higher doses and longer treatment duration.
References
6, 44, 224, 225
Last Edited
2022-06-16 17:42:21