Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus MUPIROCIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus MUPIROCIN.
COTRIM D.S. vs MUPIROCIN
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.
Mupirocin reversibly binds to bacterial isoleucyl-tRNA synthetase, inhibiting protein synthesis.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
Apply a small amount of 2% ointment or cream to affected area three times daily for 5 to 14 days.
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
moderateMupirocin + Picosulfuric acid
"The therapeutic efficacy of Picosulfuric acid can be decreased when used in combination with Mupirocin."
Intravenous: ~30 min (0.5 h). Topical: systemically absorbed amount negligible, local half-life not defined.
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%.
Renal: <1% unchanged (topical); hepatic metabolism to monic acid, eliminated renally and fecally. After IV administration, 60-70% renal, 20-30% fecal/biliary.
Category C
Category A/B
Antibiotic
Antibiotic