Comparative Pharmacology
Head-to-head clinical analysis: ILOSONE SULFA versus SULFATRIM DS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ILOSONE SULFA versus SULFATRIM DS.
ILOSONE SULFA vs SULFATRIM-DS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ilosone (erythromycin) is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. Sulfa (sulfisoxazole) is a sulfonamide that inhibits dihydropteroate synthase, blocking folate synthesis. The combination provides synergistic bacteriostatic activity.
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.
Each 5 mL suspension contains 250 mg erythromycin base and 600 mg sulfisoxazole; typical adult dose is 10 mL (2 tsp) every 6 hours, not to exceed 40 mL/day.
One double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) orally every 12 hours.
None Documented
None Documented
Erythromycin: 1.5-2 hours; Sulfisoxazole: 4-7 hours; clinical context: dose adjustment in renal impairment (CrCl <50 mL/min) needed for sulfisoxazole
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).
Renal: 70-80% as unchanged drug and active metabolite (sulfisoxazole); Biliary: 10-15% as metabolites; Fecal: <5%
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
Macrolide and Sulfonamide Antibiotic
Sulfonamide Antibiotic