Comparative Pharmacology
Head-to-head clinical analysis: BACTRIM DS versus BACTRIM PEDIATRIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BACTRIM DS versus BACTRIM PEDIATRIC.
BACTRIM DS vs BACTRIM PEDIATRIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
BACTRIM DS is a combination of sulfamethoxazole and trimethoprim. Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid (PABA), while trimethoprim inhibits dihydrofolate reductase, blocking reduction of dihydrofolate to tetrahydrofolate. This sequential blockade of folic acid synthesis leads to bactericidal action.
Bactrim (sulfamethoxazole/trimethoprim) is a combination of two antifolate agents. Sulfamethoxazole inhibits dihydropteroate synthase, blocking the conversion of PABA to dihydrofolic acid. Trimethoprim inhibits dihydrofolate reductase, preventing the reduction of dihydrofolic acid to tetrahydrofolic acid. Sequential blockade of folate synthesis leads to bacteriostasis.
One double-strength tablet (trimethoprim 160 mg-sulfamethoxazole 800 mg) orally every 12 hours.
Oral: 160 mg trimethoprim / 800 mg sulfamethoxazole (one DS tablet) every 12 hours for 14 days. For Pneumocystis jirovecii pneumonia: 15-20 mg/kg/day of trimethoprim component divided every 6-8 hours.
None Documented
None Documented
Sulfamethoxazole: 8-10 hours; Trimethoprim: 8-12 hours; prolonged in renal impairment (creatinine clearance <30 mL/min: up to 24-48 hours).
Sulfamethoxazole: 9-12 hours (prolonged in renal impairment; up to 30 hours with CrCl <30 mL/min). Trimethoprim: 8-10 hours (prolonged to 20-30 hours in severe renal impairment).
Renal: 50-70% as sulfamethoxazole (unchanged and acetylated metabolite), 40-60% as trimethoprim (unchanged); biliary: <10% for both; fecal: <4%.
Renal: sulfamethoxazole 85% (30% unchanged, rest as acetylated and glucuronide conjugates), trimethoprim 60-80% (10-30% unchanged). Fecal/biliary: <4%.
Category C
Category C
Sulfonamide Antibiotic Combination
Sulfonamide Antibiotic Combination