Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus CYCLACILLIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus CYCLACILLIN.
COTRIM D.S. vs CYCLACILLIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Cyclacillin is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
250-500 mg orally every 6 hours.
None Documented
None Documented
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.
Clinical Note
moderateCyclacillin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Cyclacillin."
Clinical Note
moderateCyclacillin + Mycophenolic acid
"The serum concentration of the active metabolites of Mycophenolic acid can be reduced when Mycophenolic acid is used in combination with Cyclacillin resulting in a loss in efficacy."
Clinical Note
moderateCyclacillin + Plicamycin
"The serum concentration of Plicamycin can be decreased when it is combined with Cyclacillin."
Clinical Note
moderate0.5–1 hour in adults with normal renal function; prolonged to 10–15 hours in anuria.
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%.
Primarily renal (90%) as unchanged drug via glomerular filtration and tubular secretion; negligible biliary/fecal elimination (<5%).
Category C
Category C
Antibiotic
Antibiotic
Cyclacillin + Valrubicin
"The serum concentration of Valrubicin can be decreased when it is combined with Cyclacillin."