Comparative Pharmacology
Head-to-head clinical analysis: SULFAMETHOXAZOLE versus SULMEPRIM PEDIATRIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFAMETHOXAZOLE versus SULMEPRIM PEDIATRIC.
SULFAMETHOXAZOLE vs SULMEPRIM PEDIATRIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Displaces dihydropteroate synthetase from its substrate para-aminobenzoic acid (PABA), inhibiting bacterial folate synthesis. Bacteriostatic against susceptible organisms.
Sulfamethoxazole inhibits bacterial dihydropteroate synthase, blocking folate synthesis; trimethoprim inhibits bacterial dihydrofolate reductase, blocking folate reduction; sequential blockade leads to bactericidal effect.
800 mg sulfamethoxazole with 160 mg trimethoprim (DS tablet) orally every 12 hours.
For Pneumocystis jirovecii pneumonia (PCP): 15-20 mg/kg/day (based on trimethoprim component) intravenously divided every 6-8 hours for 14-21 days. For other infections: 8-10 mg/kg/day (trimethoprim) orally or intravenously divided every 12 hours.
None Documented
None Documented
Clinical Note
moderateSulfamethoxazole + Gatifloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfamethoxazole + Rosoxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfamethoxazole + Trovafloxacin
"Sulfamethoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfamethoxazole + Nalidixic acid
9-11 hours in adults with normal renal function. Prolonged in renal impairment: up to 20-30 hours. In neonates, 6-12 hours.
Terminal elimination half-life: Sulfamethoxazole 9–12 hours, Trimethoprim 8–11 hours; prolonged in renal impairment (creatinine clearance <15 mL/min) requiring dose adjustment.
Primarily renal; ~80-90% excreted unchanged in urine, with 15-30% as acetylated metabolite. Biliary/fecal <5%.
Renal excretion accounts for approximately 70% (as unchanged sulfamethoxazole and trimethoprim) and 20% as metabolites; biliary/fecal elimination is minor at <10%.
Category D/X
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfamethoxazole may increase the hypoglycemic activities of Nalidixic acid."