Comparative Pharmacology
Head-to-head clinical analysis: CHLORAMPHENICOL versus SEPTRA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CHLORAMPHENICOL versus SEPTRA.
CHLORAMPHENICOL vs SEPTRA
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.
SEPTRA (trimethoprim/sulfamethoxazole) 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. This sequential blockade disrupts bacterial folate synthesis and nucleic acid production.
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.
Trimethoprim-sulfamethoxazole (TMP-SMX) 160 mg/800 mg (double strength) orally every 12 hours; for severe infections, intravenous dosing: 8-10 mg/kg/day (TMP component) divided every 6, 8, or 12 hours.
None Documented
None Documented
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
1.5-4.0 hours in adults; prolonged to 3-7 hours in neonates and up to 24 hours in severe hepatic impairment
Sulfamethoxazole: 9-12 hours (normal renal function); Trimethoprim: 8-11 hours (normal renal function). In severe renal impairment (CrCl <15 mL/min), half-life prolongs significantly (up to 24-30 hours for sulfamethoxazole, 20-30 hours for trimethoprim).
~90% renal (5-10% unchanged; remainder as inactive glucuronide), ~10% biliary/fecal
Renal excretion of unchanged sulfamethoxazole (~20%) and trimethoprim (~50-60%) with additional hepatic metabolism (acetylation, glucuronidation) of sulfamethoxazole; total renal elimination accounts for ~80-90% of the dose (sulfamethoxazole 30% parent, 40% metabolites; trimethoprim 60-80% parent, remainder as metabolites). Biliary/fecal <5%.
Category D/X
Category C
Antibiotic
Antibiotic
"The metabolism of Ticlopidine can be decreased when combined with Chloramphenicol."