Comparative Pharmacology
Head-to-head clinical analysis: CHLORAMPHENICOL versus COTRIM D S.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHLORAMPHENICOL versus COTRIM D S.
CHLORAMPHENICOL vs COTRIM D.S.
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing peptide bond formation.
COTRIM D.S. is a combination of sulfamethoxazole, a competitive inhibitor of dihydropteroate synthase, and trimethoprim, a reversible inhibitor of dihydrofolate reductase. This sequential blockade of folate synthesis leads to bactericidal activity.
50-100 mg/kg/day IV divided every 6 hours (not to exceed 4 g/day); for susceptible severe infections, 12.5-25 mg/kg IV every 6 hours.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
None Documented
None Documented
1.5-4.0 hours in adults; prolonged to 3-7 hours in neonates and up to 24 hours in severe hepatic impairment
Clinical Note
moderateChloramphenicol + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ketoconazole
"The metabolism of Ketoconazole can be decreased when combined with Chloramphenicol."
Clinical Note
moderateChloramphenicol + Ticlopidine
Sulfamethoxazole: 9-12 hours (normal renal function). Trimethoprim: 8-11 hours. Both are prolonged in renal impairment (e.g., creatinine clearance <30 mL/min: >24 hours). Clinical context: dosing interval is typically 12 hours; dose adjustment required if CrCl <30 mL/min.
~90% renal (5-10% unchanged; remainder as inactive glucuronide), ~10% biliary/fecal
Sulfamethoxazole: ~20% unchanged in urine, remainder as acetylated and glucuronide metabolites. Trimethoprim: ~50-80% unchanged in urine, remainder as oxidative metabolites. Both undergo renal excretion via glomerular filtration and tubular secretion. Total renal elimination: 70-90% of dose combined. Biliary/fecal: <10%.
Category D/X
Category C
Antibiotic
Antibiotic
"The metabolism of Ticlopidine can be decreased when combined with Chloramphenicol."