Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus TICAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus TICAR.
COTRIM D.S. vs TICAR
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.
Ticarcillin is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death. It is a time-dependent bactericidal agent.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
3 g IV every 4 hours for pseudomonal infections; 3 g IV every 6 hours for less severe infections.
None Documented
None Documented
Clinical Note
moderateTicarcillin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Ticarcillin."
Clinical Note
moderateTicarcillin + Mycophenolic acid
"The serum concentration of the active metabolites of Mycophenolic acid can be reduced when Mycophenolic acid is used in combination with Ticarcillin resulting in a loss in efficacy."
Clinical Note
moderateTicarcillin + Plicamycin
"The serum concentration of Plicamycin can be decreased when it is combined with Ticarcillin."
Clinical Note
moderateSulfamethoxazole: 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.
Terminal elimination half-life is approximately 1.2 hours in adults with normal renal function. In renal impairment, half-life may extend to 15-20 hours; dose adjustment required for CrCl <60 mL/min.
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%.
Ticarcillin is primarily excreted unchanged in urine via glomerular filtration and tubular secretion, accounting for 90-95% of the dose. Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Antibiotic
Antibiotic
Ticarcillin + Valrubicin
"The serum concentration of Valrubicin can be decreased when it is combined with Ticarcillin."