Comparative Pharmacology
Head-to-head clinical analysis: GANTRISIN PEDIATRIC versus SULFATRIM SS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: GANTRISIN PEDIATRIC versus SULFATRIM SS.
GANTRISIN PEDIATRIC vs SULFATRIM-SS
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, blocking reduction of dihydrofolate to tetrahydrofolate. Sequential blockade produces bactericidal synergy.
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.
1 double-strength tablet (160 mg trimethoprim / 800 mg sulfamethoxazole) orally every 12 hours for 10-14 days.
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: 9-12 hours (increased in renal impairment); TMP: 8-11 hours (increased in renal impairment); both prolonged in elderly.
Primarily renal (70-100% as unchanged drug and acetylated metabolites) via glomerular filtration and tubular secretion; <10% fecal.
Renal excretion of unchanged sulfamethoxazole (SMX) approximately 20%, trimethoprim (TMP) approximately 60%; biliary/fecal elimination minor (SMX <5%, TMP <10%).
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic