Comparative Pharmacology
Head-to-head clinical analysis: COTRIM D S versus TIMENTIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM D S versus TIMENTIN.
COTRIM D.S. vs TIMENTIN
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.
Timentin is a combination of ticarcillin, a penicillin-class antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), and clavulanic acid, a beta-lactamase inhibitor that irreversibly inhibits a wide range of beta-lactamase enzymes, thereby preventing degradation of ticarcillin and extending its spectrum to include beta-lactamase-producing organisms.
160 mg trimethoprim / 800 mg sulfamethoxazole (one double-strength tablet) orally every 12 hours.
3.1 g (ticarcillin 3 g + clavulanic acid 0.1 g) IV every 4-6 hours; for moderate infections, 3.1 g IV every 6 hours; for severe infections, 3.1 g IV every 4 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.
Ticarcillin: ~1.1 hours; clavulanate: ~1.0 hours. Prolonged in renal impairment (CrCl <10 mL/min: ticarcillin half-life ~13 hours).
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: 60-80% ticarcillin and 50-70% clavulanate excreted unchanged in urine via glomerular filtration and tubular secretion. Fecal: minimal.
Category C
Category C
Antibiotic
Antibiotic