Comparative Pharmacology
Head-to-head clinical analysis: SULFATRIM PEDIATRIC versus SULSTER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFATRIM PEDIATRIC versus SULSTER.
SULFATRIM PEDIATRIC vs SULSTER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfamethoxazole inhibits dihydropteroate synthase, blocking bacterial folic acid synthesis; trimethoprim inhibits dihydrofolate reductase, blocking reduction of dihydrofolate to tetrahydrofolate. Sequential blockade leads to bactericidal activity.
Sulster is a sulfonamide antibiotic that inhibits bacterial dihydropteroate synthase, blocking folate synthesis and thus bacterial DNA replication.
Sulfatrim Pediatric suspension contains sulfamethoxazole 200 mg and trimethoprim 40 mg per 5 mL. For patients >40 kg, dose is 800 mg SMX/160 mg TMP orally every 12 hours for 10-14 days.
2.5 mg orally twice daily.
None Documented
None Documented
Sulfamethoxazole: 9-11 hours; Trimethoprim: 8-10 hours; prolonged in renal impairment (e.g., CrCl <30 mL/min).
Terminal half-life 3.5-4.5 hours in normal renal function; prolonged to 10-15 hours with creatinine clearance <30 mL/min.
Renal: 50-70% of total sulfamethoxazole (SMX) and 30-50% of total trimethoprim (TMP) are excreted unchanged in urine; the remainder as metabolites; biliary/fecal excretion is minimal.
Primarily renal (60-70% unchanged), with 20-30% as glucuronide conjugate; biliary/fecal <10%.
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic