Comparative Pharmacology
Head-to-head clinical analysis: COTRIM versus TICAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COTRIM versus TICAR.
COTRIM vs TICAR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
COTRIM is a combination of trimethoprim and sulfamethoxazole; sulfamethoxazole inhibits dihydropteroate synthase, and trimethoprim inhibits dihydrofolate reductase, sequentially blocking bacterial folate synthesis.
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.
1 double-strength tablet (160 mg trimethoprim + 800 mg sulfamethoxazole) orally every 12 hours for 5-14 days; 15-20 mg/kg/day (based on trimethoprim) IV divided every 6-8 hours for severe infections.
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: 9-11 hours (normal renal function); trimethoprim: 8-10 hours. Extended in renal impairment (SMX up to 30h, TMP up to 24h).
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.
Renal: 50-70% unchanged sulfamethoxazole, 15-30% N4-acetylated metabolite; trimethoprim: 50-60% unchanged, 10-20% metabolites. Biliary/fecal: minimal.
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."