Comparative Pharmacology
Head-to-head clinical analysis: GANTRISIN PEDIATRIC versus SULFATRIM DS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: GANTRISIN PEDIATRIC versus SULFATRIM DS.
GANTRISIN PEDIATRIC vs SULFATRIM-DS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfisoxazole is a competitive inhibitor of bacterial dihydropteroate synthase, preventing the incorporation of para-aminobenzoic acid (PABA) into dihydrofolate, thereby inhibiting bacterial folic acid synthesis.
Sulfamethoxazole inhibits bacterial dihydropteroate synthase, blocking folate synthesis. Trimethoprim inhibits bacterial dihydrofolate reductase, inhibiting reduction of dihydrofolate to tetrahydrofolate. Sequential blockade of folate metabolism exerts bactericidal effect.
2-4 g initially, then 4-6 g/day in 3-6 divided doses orally, depending on severity. Alternatively, for sulfisoxazole (the active moiety), typical adult dose is 500 mg to 1 g orally every 6 hours. IM use: 50 mg/kg initially, then 100 mg/kg/day in divided doses every 6-8 hours. IV use: Not recommended in pediatric formulation.
One double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) orally every 12 hours.
None Documented
None Documented
Terminal elimination half-life is 6-12 hours (prolonged in renal impairment; up to 30 hours in patients with creatinine clearance <10 mL/min).
SMX: 9-11 hours (terminal); TMP: 8-10 hours; prolonged in renal impairment (creatinine clearance <30 mL/min: up to 20-30 hours for both).
Primarily renal (70-100% as unchanged drug and acetylated metabolites) via glomerular filtration and tubular secretion; <10% fecal.
Renal: 50-70% of total sulfamethoxazole (SMX) and 30% of trimethoprim (TMP) as unchanged drug via glomerular filtration and tubular secretion; 20-40% of SMX as N4-acetylated metabolite; biliary excretion accounts for <5%.
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic