Comparative Pharmacology
Head-to-head clinical analysis: SULFAMETHOXAZOLE AND TRIMETHOPRIM DOUBLE STRENGTH versus TICAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFAMETHOXAZOLE AND TRIMETHOPRIM DOUBLE STRENGTH versus TICAR.
SULFAMETHOXAZOLE AND TRIMETHOPRIM DOUBLE STRENGTH vs TICAR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfamethoxazole inhibits bacterial dihydropteroate synthase, blocking folic acid synthesis. Trimethoprim inhibits bacterial dihydrofolate reductase, blocking reduction of dihydrofolate to tetrahydrofolate. Sequential blockade produces bactericidal effect.
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.
One double-strength tablet (160 mg trimethoprim/800 mg sulfamethoxazole) orally every 12 hours.
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; trimethoprim: 8-11 hours. In severe renal impairment (CrCl <15 mL/min), half-life prolongs significantly (up to 30 hours for trimethoprim).
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.
Both sulfamethoxazole and trimethoprim are primarily excreted via the kidneys. Sulfamethoxazole: ~30% as unchanged drug, ~50% as N4-acetyl metabolite; trimethoprim: ~80% as unchanged drug. Fecal elimination is minimal (<5%).
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 D/X
Category C
Antibiotic
Antibiotic
Ticarcillin + Valrubicin
"The serum concentration of Valrubicin can be decreased when it is combined with Ticarcillin."