Comparative Pharmacology
Head-to-head clinical analysis: BACTRIM versus BACTRIM PEDIATRIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BACTRIM versus BACTRIM PEDIATRIC.
BACTRIM vs BACTRIM PEDIATRIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
BACTRIM (sulfamethoxazole/trimethoprim) inhibits bacterial folate synthesis. Sulfamethoxazole, a sulfonamide, inhibits dihydropteroate synthase, blocking PABA incorporation into dihydrofolic acid. Trimethoprim inhibits dihydrofolate reductase, blocking conversion of dihydrofolic acid to tetrahydrofolic acid. Sequential blockade leads to bactericidal effect.
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.
1 DS tablet (160 mg TMP/800 mg SMX) orally every 12 hours for 10-14 days.
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: 9-12 hours (prolonged in renal impairment); Trimethoprim: 8-10 hours (prolonged in renal impairment).
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: sulfamethoxazole 20-30% unchanged, trimethoprim 40-70% unchanged; biliary/fecal: minimal (<10%) for both components.
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