Trimethoprim-Sulfamethoxazole

Always used as a fixed dose combination of Trimethoprim-Sulfamethoxazole in ratio of 1:5. Dose of Trimethoprim(TMP) is used for calculation purposes.

Mild to Moderate Infections

• 4 mg TMP/kg/dose PO – 12 hrly  

Serious Infections

• ORAL  : 4 mg TMP/kg/dose – 6 hrly 
• IV dose: 4 mg TMP/kg/dose – 6  hrly as infusion

Acute Otitis Media

Acute otitis media in pediatric patients due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae

3-5 mg TMP/kg/dose –  12hrly for 10 days  

Pneumocystis (Carinii) Jiroveci Pneumonia

• Treatment  : 4 mg TMP/kg/dose Oral/IV – 6hrly for 21 days  
• Prophylaxis: 75 mg TMP/m²/dose Oral –  12 hrly for 3 days/week on consecutive or alternate days  

Shigellosis

• Oral- 4 mg TMP/kg/dose – 12hrly for 5 days  
• IV –   4 mg TMP/kg/dose  – 12hr for 5 days

Urinary Tract Infection

• 4 mg TMP/kg/dose PO – 12hr for 7-14 days if serious infection  
• 4 mg TMP/kg/dose IV –   12hr for 14 days if serious infection
• Prophylaxis: 2 mg TMP/kg/dose PO daily  or 5 mg TMP/kg/dose twice weekly

Skin/soft Tissue Infection Due to Community Acquired MRSA (Off-label)

4-6 mg TMP/kg/dose oral 12hrly for 5-10 days; (add beta-lactam antibiotic to regimen if beta-hemolytic Streptococcus spp also suspected) 

Cautions for use

• Age <2 months
• Sulfonamides should not be used to treat group A beta-hemolytic streptococcal infections; they will not eradicate streptococcus or prevent rheumatic fever
• Documented megaloblastic or folate deficiency anemia
• Hemolysis may occur if administered to patients with G6PD deficiency

Dosage Forms & Strengths

(Trimethoprim/Sulfamethoxazole)

Oral solution

• Septran / Bactrim* (40mg/200mg)/5mL
• Septran DS * (80mg/400mg)/5 ml

Tablet

• Septran* 80mg/400mg
• Septran DS/Bactrim Forte* 160mg/800mg

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