Trimethoprim/sulfamethoxazole

(Redirected from Sulfatrim)

Trimethoprim/sulfamethoxazole, sold under the brand name Bactrim among others, is a fixed-dose combination antibiotic medication used to treat a variety of bacterial infections.[2] It consists of one part trimethoprim to five parts sulfamethoxazole.[7] It is used to treat urinary tract infections, methicillin-resistant Staphylococcus aureus (MRSA) skin infections, travelers' diarrhea, respiratory tract infections, and cholera, among others.[2][7] It is used both to treat and prevent pneumocystis pneumonia and toxoplasmosis in people with HIV/AIDS and other causes of immunosuppression.[2] It can be given orally (swallowed by mouth) or intravenous infusion (slowly injected into a vein with an IV).[2]

Trimethoprim/sulfamethoxazole
Trimethoprim (top) and sulfamethoxazole (bottom)
Combination of
SulfamethoxazoleSulfonamide antibiotic
TrimethoprimDihydrofolate reductase inhibitor
Clinical data
Trade namesBactrim, Cotrim, Septra, others
Other namesTMP/SMX, cotrimoxazole, Co-trimoxazole (BAN UK)
AHFS/Drugs.comMonograph
License data
Pregnancy
category
Routes of
administration
oral, intravenous[2]
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
ChemSpider
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
  (verify)

Trimethoprim/sulfamethoxazole is on the World Health Organization's List of Essential Medicines.[8] It is available as a generic medication.[7][9] In 2022, it was the 143rd most commonly prescribed medication in the United States, with more than 3 million prescriptions.[10][11]

Medical uses

edit

Trimethoprim/sulfamethoxazole generally kills bacteria,[2] by blocking the microorganisms' ability to make and to use folate.[2]

Pneumocystis jirovecii pneumonia

edit

Trimethoprim/sulfamethoxazole (TMP/SMX) is the medicine most commonly used to prevent Pneumocystis jirovecii pneumonia (PCP)[12] People who get Pneumocystis pneumonia have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines (such as corticosteroid, monoclonal antibody and immunosuppressants) that reduce the body's ability to fight bacterial and viral infections. People with HIV/AIDS are less likely to get Pneumocystis pneumonia as a result of antiretroviral therapy (ART). However, Pneumocystis pneumonia is still a substantial public health problem. Most of what is scientifically known about Pneumocystis pneumonia and its treatment comes from studying people with HIV/AIDS.[12]

Susceptibility

edit

Organisms against which trimethoprim/sulfamethoxazole can be effective include:[13][14]

The only notable nonsusceptible organisms are Pseudomonas aeruginosa, the mycoplasmae[14] and Francisella tularensis (the causative organism of tularaemia).[15][16]

Pregnancy and breast feeding

edit

Its use during pregnancy is contraindicated, although it has been placed in Australian pregnancy category C.[13] Its use during the first trimester (during organogenesis) and 12 weeks prior to pregnancy has been associated with an increased risk of congenital malformations, especially malformations associated with maternal folic acid deficiency (which is most likely related to the mechanism of action of co-trimoxazole) such as neural tube defects such as spina bifida, cardiovascular malformations (e.g. Ebstein's anomaly), urinary tract defects, oral clefts, and club foot in epidemiological studies.[13] Its use later on during pregnancy also increases the risk of preterm labour (odds ratio: 1.51) and low birth weight (odds ratio: 1.67).[17][18] Animal studies have yielded similarly discouraging results.[3]

It appears to be safe for use during breastfeeding as long as the baby is healthy.[19]

Babies

edit

Its use in those less than 2 months of age is not recommended due to the risk of adverse side effects.[20]

Adverse effects

edit

Common side effects include nausea, vomiting, rash, and diarrhea.[2] Severe allergic reactions and Clostridioides difficile infection may occasionally occur.[2] Its use in pregnancy is not recommended.[2][19] It appears to be safe for use during breastfeeding as long as the baby is healthy.[19]

Contraindications

edit

Contraindications include the following:[13][5]

  • Known hypersensitivity to trimethoprim, sulphonamides or any other ingredients in the formulations
  • Pregnancy
  • Severe liver failure, marked liver parenchymal damage, or jaundice.
  • Serious haematological disorders and porphyria (due to the sulfonamide component of the preparation).
  • Severe chronic kidney disease (CrCl <15 ml/min) where repeated measurements of the plasma concentration cannot be performed

Interactions

edit

Its use is advised against in people being concomitantly treated with:[13][3][5][6][21][22]

  • ACE inhibitors like captopril, enalapril, lisinopril, perindopril, and ramipril due to the potential for additive hyperkalaemic effects[5]
  • Prilocaine — additive risk of methaemoglobinaemia
  • Antiarrhythmics like amiodarone (increased risk of ventricular arrhythmias) and dofetilide (increased risk of QT interval prolongation)
  • Antibacterials like dapsone (increases plasma levels of both drugs), methenamine (increased risk of crystalluria) and rifampicin (as it may lead to an increased plasma level of rifampicin and lower plasma levels of trimethoprim)
  • Anticoagulants like warfarin and acenocoumarol — anticoagulant effects of either drug is potentiated by this combination
  • Sulfonylureas — effects enhanced
  • Phenytoin, half-life of phenytoin is increased
  • Antifolates like pyrimethamine, proguanil and methotrexate increase the risk of associated side effects like bone marrow toxicity, folic acid supplementation should be considered. A significant risk of megaloblastic anaemia exists with doses of pyrimethamine in excess of 25 mg/wk.
  • Antivirals, more specifically, lamivudine (increased plasma concentrations of lamivudine), zalcitabine (increased plasma concentrations of zalcitabine) and zidovudine (increased risk of haematological reactions)
  • Procainamide and/or amantadine may have their plasma concentrations increased bilaterally or unilaterally.
  • Clozapine and other antipsychotics — increased risk of haematological side effects
  • Nucleoside analogue antineoplastics like azathioprine and mercaptopurine — increased risk of haematological toxicity
  • Digoxin — increase in digoxin levels in a proportion of elderly patients
  • Diuretics — elderly patients receiving thiazide diuretics are at a heightened risk for developing thrombocytopaenia while on co-trimoxazole
  • Ciclosporin — patients who have received a kidney transplant and are receiving co-trimoxazole and ciclosporin concomitantly are at an increased risk of having a reversible deterioration in their kidney function.
  • Spironolactone — concurrent use can increase the likelihood of hyperkalemia, especially in the elderly. The trimethoprim portion acts to prevent potassium excretion in the distal tubule of the nephron.[23]
  • Potassium aminobenzoate — effects of sulfonamides (like Sulfamethoxazole) inhibited.
  • Laboratory tests — trimethoprim and sulfonamides have been reported to interfere with diagnostic tests, including serum-methotrexate and elevated serum creatinine levels,[24] also urea, urinary glucose and urobilinogen tests.

Overdose

edit

Likely signs of toxicity include:[3]

  • Nausea
  • Vomiting
  • Dizziness
  • Headache
  • Mental depression
  • Confusion
  • Thrombocytopenia
  • Uremia
  • Bone marrow depression
  • Loss of appetite
  • Colic
  • Drowsiness
  • Unconsciousness

The recommended treatment for overdose includes:[3]

  • Administration of activated charcoal
  • Stomach pumping
  • General supportive measures
  • Haemodialysis, which is moderately effective in clearing co-trimoxazole from the plasma.
  • Calcium folinate treatment in cases of blood dyscrasias
  • Forcing oral fluids

Alkalinisation of the urine may reduce the toxicity of sulfamethoxazole, but it may increase the toxic effects of trimethoprim.[3]

Pharmacology

edit
 
Tetrahydrofolate synthesis pathway

The synergy between trimethoprim and sulfamethoxazole was first described in the late 1960s.[25][26][27] Trimethoprim and sulfamethoxazole have a greater effect when given together than when given separately, because they inhibit successive steps in the folate synthesis pathway. They are given in a one-to-five ratio in their tablet formulations so that when they enter the body their concentration in the blood and tissues is roughly one-to-twenty — the exact ratio required for a peak synergistic effect between the two.[14]

Sulfamethoxazole, a sulfonamide, induces its therapeutic effects by interfering with the de novo (that is, from within the cell) synthesis of folate inside microbial organisms such as protozoa, fungi and bacteria. It does this by competing with p-aminobenzoic acid (PABA) in the biosynthesis of dihydrofolate.[14]

Trimethoprim serves as a competitive inhibitor of dihydrofolate reductase (DHFR), hence inhibiting the de novo synthesis of tetrahydrofolate, the biologically active form of folate.[14]

Tetrahydrofolate is crucial in the synthesis of purines, thymidine, and methionine which are needed for the production of DNA and proteins[28] during bacterial replication.

The effects of trimethoprim causes a backlog of dihydrofolate (DHF) and this backlog can work against the inhibitory effect the drug has on tetrahydrofolate biosynthesis. This is where the sulfamethoxazole comes in; its role is in depleting the excess DHF by preventing it from being synthesised in the first place.[14]

Co-trimoxazole was claimed to be more effective than either of its components individually in treating bacterial infections, although this was later disputed.[29][30]

Pharmacokinetics of co-trimoxazole[13][3]
Component Tmax (h) Vd (L) Protein binding t1/2 (h) Excretion
Sulfamethoxazole 1-4 20 66% 8-10 Renal
Trimethoprim 1-4 130 42-45% 10 Renal

Society and culture

edit
edit
Indications for co-trimoxazole
Indication  
FDA-labelled indication?
 
TGA-labelled indication?
 
MHRA-labelled indication?
Literature support
Acute infective exacerbation of COPD Yes No No Clinical trials are lacking.
Prophylaxis in HIV-infected individuals No No No Effective in one Ugandan study on morbidity, mortality, CD4-cell count, and viral load in HIV infection.[31]
Otitis media Paediatric population only No Yes Clinical trials have confirmed its efficacy in chronic active otitis media[32] and acute otitis media.[33]
Travellers' diarrhea, treatment & prophylaxis Yes No No Clinical trials have confirmed its efficacy as a treatment for travellers' diarrhea.[34][35][36]
Urinary tract infection Yes No Yes Clinical trials have confirmed its efficacy in this indication.[14]
Bacterial infections
Acne vulgaris No No No At least one clinical trial supports its use in this indication.[37]
Listeria No Yes No Well-designed clinical trials are lacking.
Melioidosis No Yes No Clinical trials have confirmed its efficacy, with or without adjunctive doxycycline; although, co-trimoxazole alone seems preferable.[38][39][40]
Pertussis (whooping cough) No No No One cochrane review supports its efficacy in preventing the spread of pertussis.[41]
Shigellosis Yes Yes No Generally accepted treatment for shigellosis.[42] A recent Cochrane review found that while it is an effective treatment for shigellosis it also produces more significant adverse effects than other antibiotic drugs.[43]
Staphylococcus aureus infections No No No In vitro and in vivo activity against both non-resistant and methicillin-resistant Staphylococcus aureus (MRSA) infections.[44][45][46][47][48][49][50]
Tuberculosis No No No In vitro and in vivo activity against both nonresistant and MDR strains of TB.[51][52][53]
Whipple's disease No No No Co-trimoxazole is the recommended standard treatment for whipple's disease in some treatment protocols.[54][55][56]
Fungal and protozoal infections
Isosporiasis No No No Clinical trials have confirmed its use in this indication.[57]
Malaria No No No Clinical trials have confirmed its efficacy in both the treatment and prevention of malaria.[58]
Pneumocystis jirovecii pneumonia Yes Yes Yes Its use as a prophylactic treatment is supported by one clinical trial involving children with acute lymphoblastic leukaemia.[59] Other than this and one other clinical trial into its efficacy as a treatment for pneumocystis pneumonia,[60] data on its use in both the treatment and prevention of pneumocystis pneumonia is significantly lacking.
Toxoplasmosis Yes Prevention only Yes Clinical trials have confirmed its prophylactic and therapeutic utility in cases of toxoplasmosis.[61][62][63][64][65][66]

Brand names

edit

Trimethoprim/sulfamethoxazole may be abbreviated as SXT, SMZ-TMP, TMP-SMX, TMP-SMZ, or TMP-sulfa.[citation needed] The generic British Approved Name (BAN) Co-trimoxazole is used for trimethoprim/sulfamethoxazole manufactured and sold by many different companies.[67]

The following list of brand names is incomplete:

  • Bactrim, Bactrimel (manufactured by Roche and distributed in Europe)
  • Bactrom (Venezuela)
  • Bibactin (manufactured by PPM and distributed in Cambodia and some African countries)
  • Biseptol
  • Sumetrolim
  • Co-trimoxazole (used as generic UK name)
  • Cotrim
  • Deprim (AFT Pharmaceuticals)
  • Diseptyl (Israel)
  • Graprima Forte Kaplet (manufactured by PT Graha Farma and distributed in Indonesia)
  • Infectrin, Bactrim (Brazil)
  • Novo-Trimel[68]
  • Primadex (manufactured by Dexa Medica and distributed in Indonesia)
  • Primotren (Lek in Slovenia and other countries)
  • Resprim
  • Sanprima (manufactured by PT Sanbe Farma and distributed in Indonesia)
  • Septra (Aspen Pharmacare and formerly GlaxoSmithKline)
  • Septram (Panama)
  • Septran (GlaxoSmithKline)[69]
  • Septrin (Spain)[70]
  • Sulfatrim
  • Teva-Trimel
  • Trisul
  • Vactrim (manufactured and distributed in Laos)

Economics

edit

Trimethoprim/sulfamethoxazole is relatively inexpensive as of 2019.[9]

References

edit
  1. ^ "Sulfamethoxazole / trimethoprim Use During Pregnancy". Drugs.com. 8 March 2019. Archived from the original on 6 September 2015. Retrieved 15 April 2020.
  2. ^ a b c d e f g h i j "Co-trimoxazole". The American Society of Health-System Pharmacists. Archived from the original on 6 September 2015. Retrieved 1 August 2015.
  3. ^ a b c d e f g "Bactrim DS tablet blister pack". Therapeutic Goods Administration (TGA). Archived from the original on 29 December 2021. Retrieved 28 December 2021.
  4. ^ "TGA eBS - Product and Consumer Medicine Information Licence". Archived from the original on 29 December 2021. Retrieved 29 December 2021.
  5. ^ a b c d "Co-Trimoxazole 80 mg/400 mg Tablets - Summary of Product Characteristics (SmPC)". (emc). 1 August 2021. Archived from the original on 29 December 2021. Retrieved 28 December 2021.
  6. ^ a b "Bactrim DS- sulfamethoxazole and trimethoprim tablet Bactrim- sulfamethoxazole and trimethoprim tablet". DailyMed. Archived from the original on 29 December 2021. Retrieved 28 December 2021.
  7. ^ a b c Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 105. ISBN 9781284057560.
  8. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  9. ^ a b Brown D, Edwards H, Buckley T, Aitken RL (2019). Lewis's Medical-Surgical Nursing EBook: Assessment and Management of Clinical Problems. Elsevier Health Sciences. p. 1173. ISBN 978-0-7295-8708-2. Archived from the original on 29 August 2021. Retrieved 30 March 2020.
  10. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  11. ^ "Sulfamethoxazole; Trimethoprim Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
  12. ^ a b "Pneumocystis pneumonia". U.S. Centers for Disease Control and Prevention (CDC). 13 October 2021. Archived from the original on 26 July 2021. Retrieved 30 December 2021.
  13. ^ a b c d e f "trimethoprim/sulfamethoxazole (Rx)". Medscape Reference. Archived from the original on 16 January 2014. Retrieved 13 January 2014.
  14. ^ a b c d e f g Wormser GP, Keusch GT, Heel RC (December 1982). "Co-trimoxazole (trimethoprim-sulfamethoxazole): an updated review of its antibacterial activity and clinical efficacy". Drugs. 24 (6): 459–518. doi:10.2165/00003495-198224060-00002. PMID 6759092. S2CID 209121818.
  15. ^ "Tularemia" (PDF). Infectious Disease Epidemiology Section. Louisiana Office of Public Health. 17 July 2011. Archived (PDF) from the original on 23 February 2014. Retrieved 12 February 2014.
  16. ^ Harik NS (July 2013). "Tularemia: epidemiology, diagnosis, and treatment". Pediatric Annals. 42 (7): 288–292. doi:10.3928/00904481-20130619-13. PMID 23805970.
  17. ^ Yang J, Xie RH, Krewski D, Wang YJ, Walker M, Wen SW (May 2011). "Exposure to trimethoprim/sulfamethoxazole but not other FDA category C and D anti-infectives is associated with increased risks of preterm birth and low birth weight". International Journal of Infectious Diseases. 15 (5): e336–e341. doi:10.1016/j.ijid.2011.01.007. PMID 21345707.
  18. ^ Santos F, Sheehy O, Perreault S, Ferreira E, Berard A (October 2011). "Exposure to anti-infective drugs during pregnancy and the risk of small-for-gestational-age newborns: a case-control study". BJOG. 118 (11): 1374–1382. doi:10.1111/j.1471-0528.2011.03041.x. PMID 21749628. S2CID 21014782.
  19. ^ a b c "Sulfamethoxazole / trimethoprim Pregnancy and Breastfeeding Warnings". Archived from the original on 6 September 2015. Retrieved 31 August 2015. An extensive systematic review of sulfonamide usage near term and during breastfeeding found no side effects in infants; the authors concluded that use of this combination drug during breastfeeding presents no risk of neonatal kernicterus... LactMed: Use is considered acceptable when breastfeeding healthy, full-term infants after the newborn period
  20. ^ "Drugs & Medications". WebMD. Archived from the original on 19 April 2019. Retrieved 19 April 2019.
  21. ^ Joint Formulary Committee (2013). British National Formulary (BNF) (65 ed.). London, UK: Pharmaceutical Press. ISBN 978-0-85711-084-8.
  22. ^ Rossi S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.
  23. ^ Juvet T, Gourineni VC, Ravi S, Zarich SW (September 2013). "Life-threatening hyperkalemia: a potentially lethal drug combination". Connecticut Medicine. 77 (8): 491–3. PMID 24156179.
  24. ^ Gentry CA, Nguyen AT (December 2013). "An evaluation of hyperkalemia and serum creatinine elevation associated with different dosage levels of outpatient trimethoprim-sulfamethoxazole with and without concomitant medications". The Annals of Pharmacotherapy. 47 (12): 1618–26. doi:10.1177/1060028013509973. PMID 24259630. S2CID 19395548.
  25. ^ Bushby SR, Hitchings GH (May 1968). "Trimethoprim, a sulphonamide potentiator". British Journal of Pharmacology and Chemotherapy. 33 (1): 72–90. doi:10.1111/j.1476-5381.1968.tb00475.x. PMC 1570262. PMID 5301731.
  26. ^ Böhni E (1969). "[Comparative bacteriological investigations with the combination trimethoprim/sulfamethoxazole in vitro and in vivo]". Chemotherapy. 14 (Suppl): Suppl:1–Suppl21. doi:10.1159/000220651. PMID 4908562.
  27. ^ Böhni E (November 1969). "Chemotherapeutic activity of the combination of trimethoprim and sulphamethoxazole in infections of mice". Postgraduate Medical Journal. 45 (Suppl): Suppl:18–Suppl:21. PMID 4902845.
  28. ^ "Tetrahydrofolic acid". PubChem. U.S. National Library of Medicine. Archived from the original on 26 February 2018. Retrieved 26 February 2018.
  29. ^ Trubiano JA, Grayson ML (2017). "Trimethoprim and Trimethoprim–Sulfamethoxazole (Cotrimoxazole)". In Grayson ML, Cosgrove S, Crowe S, Hope W, McCarthy J, Mills J, Mouton JW, Paterson D (eds.). Kucers' the Use of Antibiotics (7th ed.). CRC Press. pp. 1625, 1634. doi:10.1201/9781498747967. ISBN 9781498747967.
  30. ^ Brumfitt W, Hamilton-Miller JM (December 1993). "Reassessment of the rationale for the combinations of sulphonamides with diaminopyrimidines". Journal of Chemotherapy. 5 (6): 465–469. doi:10.1080/1120009X.1993.11741097. PMID 8195839.
  31. ^ Mermin J, Lule J, Ekwaru JP, Malamba S, Downing R, Ransom R, et al. (October 2004). "Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda". Lancet. 364 (9443): 1428–1434. doi:10.1016/S0140-6736(04)17225-5. PMID 15488218. S2CID 23402992. Archived from the original on 18 January 2021. Retrieved 12 September 2020.
  32. ^ van der Veen EL, Rovers MM, Albers FW, Sanders EA, Schilder AG (May 2007). "Effectiveness of trimethoprim/sulfamethoxazole for children with chronic active otitis media: a randomized, placebo-controlled trial". Pediatrics. 119 (5): 897–904. doi:10.1542/peds.2006-2787. hdl:1874/25986. PMID 17473089. S2CID 23835227.
  33. ^ Leiberman A, Leibovitz E, Piglansky L, Raiz S, Press J, Yagupsky P, et al. (March 2001). "Bacteriologic and clinical efficacy of trimethoprim-sulfamethoxazole for treatment of acute otitis media". The Pediatric Infectious Disease Journal. 20 (3): 260–264. doi:10.1097/00006454-200103000-00009. PMID 11303827. S2CID 45262990.
  34. ^ Ericsson CD, Johnson PC, Dupont HL, Morgan DR, Bitsura JA, de la Cabada FJ (February 1987). "Ciprofloxacin or trimethoprim-sulfamethoxazole as initial therapy for travelers' diarrhea. A placebo-controlled, randomized trial". Annals of Internal Medicine. 106 (2): 216–220. doi:10.7326/0003-4819-106-2-216. PMID 3541724.
  35. ^ Ericsson CD, DuPont HL, Mathewson JJ, West MS, Johnson PC, Bitsura JA (January 1990). "Treatment of traveler's diarrhea with sulfamethoxazole and trimethoprim and loperamide". JAMA. 263 (2): 257–261. doi:10.1001/jama.1990.03440020091039. PMID 2403603.
  36. ^ Rendi-Wagner P, Kollaritsch H (March 2002). "Drug prophylaxis for travelers' diarrhea". Clinical Infectious Diseases. 34 (5): 628–633. doi:10.1086/338640. PMID 11803509.
  37. ^ Nordin K, Hallander H, Fredriksson T, Rylander C (1978). "A clinical and bacteriological evaluation of the effect of sulphamethoxazole-trimethoprim in acne vulgaris, resistant to prior therapy with tetracyclines". Dermatologica. 157 (4): 245–253. doi:10.1159/000250840. PMID 150980.
  38. ^ Chetchotisakd P, Chaowagul W, Mootsikapun P, Budhsarawong D, Thinkamrop B (January 2001). "Maintenance therapy of melioidosis with ciprofloxacin plus azithromycin compared with cotrimoxazole plus doxycycline". The American Journal of Tropical Medicine and Hygiene. 64 (1–2): 24–27. doi:10.4269/ajtmh.2001.64.24. PMID 11425157.
  39. ^ Chusri S, Hortiwakul T, Charoenmak B, Silpapojakul K (November 2012). "Outcomes of patients with melioidosis treated with cotrimoxazole alone for eradication therapy". The American Journal of Tropical Medicine and Hygiene. 87 (5): 927–932. doi:10.4269/ajtmh.2012.12-0136. PMC 3516270. PMID 23033403.
  40. ^ Chetchotisakd P, Chierakul W, Chaowagul W, Anunnatsiri S, Phimda K, Mootsikapun P, et al. (March 2014). "Trimethoprim-sulfamethoxazole versus trimethoprim-sulfamethoxazole plus doxycycline as oral eradicative treatment for melioidosis (MERTH): a multicentre, double-blind, non-inferiority, randomised controlled trial". Lancet. 383 (9919): 807–814. doi:10.1016/S0140-6736(13)61951-0. PMC 3939931. PMID 24284287.
  41. ^ Altunaiji S, Kukuruzovic R, Curtis N, Massie J (July 2007). "Antibiotics for whooping cough (pertussis)". The Cochrane Database of Systematic Reviews. 2013 (3): CD004404. doi:10.1002/14651858.CD004404.pub3. PMC 11322855. PMID 17636756.
  42. ^ Sureshbabu J, Venugopalan P, Abuhammour W (25 June 2012). Fennelly G, Windle ML, Lutwick LI, Tolan Jr RW, Steele RW (eds.). "Shigella Infection Medication". Medscape Reference. WebMD. Archived from the original on 8 January 2014. Retrieved 8 January 2014.
  43. ^ Christopher PR, David KV, John SM, Sankarapandian V (August 2010). "Antibiotic therapy for Shigella dysentery". The Cochrane Database of Systematic Reviews. 2010 (8): CD006784. doi:10.1002/14651858.CD006784.pub4. PMC 6532574. PMID 20687081.
  44. ^ Grim SA, Rapp RP, Martin CA, Evans ME (February 2005). "Trimethoprim-sulfamethoxazole as a viable treatment option for infections caused by methicillin-resistant Staphylococcus aureus". Pharmacotherapy. 25 (2): 253–264. doi:10.1592/phco.25.2.253.56956. PMID 15767239. S2CID 31546680.
  45. ^ Cenizal MJ, Skiest D, Luber S, Bedimo R, Davis P, Fox P, et al. (July 2007). "Prospective randomized trial of empiric therapy with trimethoprim-sulfamethoxazole or doxycycline for outpatient skin and soft tissue infections in an area of high prevalence of methicillin-resistant Staphylococcus aureus". Antimicrobial Agents and Chemotherapy. 51 (7): 2628–2630. doi:10.1128/AAC.00206-07. PMC 1913240. PMID 17502411.
  46. ^ LaPlante KL, Leonard SN, Andes DR, Craig WA, Rybak MJ (June 2008). "Activities of clindamycin, daptomycin, doxycycline, linezolid, trimethoprim-sulfamethoxazole, and vancomycin against community-associated methicillin-resistant Staphylococcus aureus with inducible clindamycin resistance in murine thigh infection and in vitro pharmacodynamic models". Antimicrobial Agents and Chemotherapy. 52 (6): 2156–2162. doi:10.1128/AAC.01046-07. PMC 2415789. PMID 18411321.
  47. ^ Pappas G, Athanasoulia AP, Matthaiou DK, Falagas ME (April 2009). "Trimethoprim-sulfamethoxazole for methicillin-resistant Staphylococcus aureus: a forgotten alternative?". Journal of Chemotherapy. 21 (2): 115–126. doi:10.1179/joc.2009.21.2.115. PMID 19423463. S2CID 8425281.
  48. ^ Goldberg E, Paul M, Talker O, Samra Z, Raskin M, Hazzan R, et al. (August 2010). "Co-trimoxazole versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia: a retrospective cohort study". The Journal of Antimicrobial Chemotherapy. 65 (8): 1779–1783. doi:10.1093/jac/dkq179. PMID 20507860.
  49. ^ Cadena J, Nair S, Henao-Martinez AF, Jorgensen JH, Patterson JE, Sreeramoju PV (December 2011). "Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus". Antimicrobial Agents and Chemotherapy. 55 (12): 5430–5432. doi:10.1128/AAC.00706-11. PMC 3232808. PMID 21930870.
  50. ^ Avery LM, Steed ME, Woodruff AE, Hasan M, Rybak MJ (November 2012). "Daptomycin-nonsusceptible vancomycin-intermediate staphylococcus aureus vertebral osteomyelitis cases complicated by bacteremia treated with high-dose daptomycin and trimethoprim-sulfamethoxazole". Antimicrobial Agents and Chemotherapy. 56 (11): 5990–5993. doi:10.1128/AAC.01046-12. PMC 3486608. PMID 22869580.
  51. ^ Forgacs P, Wengenack NL, Hall L, Zimmerman SK, Silverman ML, Roberts GD (November 2009). "Tuberculosis and trimethoprim-sulfamethoxazole". Antimicrobial Agents and Chemotherapy. 53 (11): 4789–4793. doi:10.1128/AAC.01658-08. PMC 2772331. PMID 19564358.
  52. ^ Vilchèze C, Jacobs WR (October 2012). "The combination of sulfamethoxazole, trimethoprim, and isoniazid or rifampin is bactericidal and prevents the emergence of drug resistance in Mycobacterium tuberculosis". Antimicrobial Agents and Chemotherapy. 56 (10): 5142–5148. doi:10.1128/AAC.00832-12. PMC 3457372. PMID 22825115.
  53. ^ Alsaad N, van Altena R, Pranger AD, van Soolingen D, de Lange WC, van der Werf TS, et al. (August 2013). "Evaluation of co-trimoxazole in the treatment of multidrug-resistant tuberculosis". The European Respiratory Journal. 42 (2): 504–512. doi:10.1183/09031936.00114812. PMID 23100498.
  54. ^ Fenollar F, Raoult D (January 2001). "Whipple's disease". Clinical and Diagnostic Laboratory Immunology. 8 (1): 1–8. doi:10.1128/CDLI.8.1.1-8.2001. PMC 96003. PMID 11139188.
  55. ^ Ojeda E, Cosme A, Lapaza J, Torrado J, Arruabarrena I, Alzate L (February 2010). "Whipple's disease in Spain: a clinical review of 91 patients diagnosed between 1947 and 2001". Revista Espanola de Enfermedades Digestivas. 102 (2): 108–123. doi:10.4321/s1130-01082010000200006. PMID 20361847.
  56. ^ Puéchal X (November 2013). "Whipple's disease". Postgraduate Medical Journal. 89 (1057): 659–665. doi:10.1136/postgradmedj-2012-202684rep. PMID 24129033. S2CID 24695700.
  57. ^ Lagrange-Xélot M, Porcher R, Sarfati C, de Castro N, Carel O, Magnier JD, et al. (February 2008). "Isosporiasis in patients with HIV infection in the highly active antiretroviral therapy era in France". HIV Medicine. 9 (2): 126–130. doi:10.1111/j.1468-1293.2007.00530.x. PMID 18257775. S2CID 26120155.
  58. ^ Manyando C, Njunju EM, D'Alessandro U, Van Geertruyden JP (2013). "Safety and efficacy of co-trimoxazole for treatment and prevention of Plasmodium falciparum malaria: a systematic review". PLOS ONE. 8 (2): e56916. Bibcode:2013PLoSO...856916M. doi:10.1371/journal.pone.0056916. PMC 3579948. PMID 23451110.
  59. ^ Agrawal AK, Chang PP, Feusner J (January 2011). "Twice weekly Pneumocystis jiroveci pneumonia prophylaxis with trimethoprim-sulfamethoxazole in pediatric patients with acute lymphoblastic leukemia". Journal of Pediatric Hematology/Oncology. 33 (1): e1–e4. doi:10.1097/MPH.0b013e3181fd6fca. PMID 21102354. S2CID 42371307.
  60. ^ Safrin S, Finkelstein DM, Feinberg J, Frame P, Simpson G, Wu A, et al. (May 1996). "Comparison of three regimens for treatment of mild to moderate Pneumocystis carinii pneumonia in patients with AIDS. A double-blind, randomized, trial of oral trimethoprim-sulfamethoxazole, dapsone-trimethoprim, and clindamycin-primaquine. ACTG 108 Study Group". Annals of Internal Medicine. 124 (9): 792–802. doi:10.7326/0003-4819-124-9-199605010-00003. PMID 8610948. S2CID 40999772.
  61. ^ Canessa A, Del Bono V, De Leo P, Piersantelli N, Terragna A (February 1992). "Cotrimoxazole therapy of Toxoplasma gondii encephalitis in AIDS patients". European Journal of Clinical Microbiology & Infectious Diseases. 11 (2): 125–130. doi:10.1007/BF01967063. PMID 1396726. S2CID 13621055.
  62. ^ Torre D, Casari S, Speranza F, Donisi A, Gregis G, Poggio A, et al. (June 1998). "Randomized trial of trimethoprim-sulfamethoxazole versus pyrimethamine-sulfadiazine for therapy of toxoplasmic encephalitis in patients with AIDS. Italian Collaborative Study Group". Antimicrobial Agents and Chemotherapy. 42 (6): 1346–1349. doi:10.1128/AAC.42.6.1346. PMC 105601. PMID 9624473.
  63. ^ Muñoz P, Arencibia J, Rodríguez C, Rivera M, Palomo J, Yañez J, et al. (April 2003). "Trimethoprim-sulfamethoxazole as toxoplasmosis prophylaxis for heart transplant recipients". Clinical Infectious Diseases. 36 (7): 932–3, author reply 933. doi:10.1086/368209. PMID 12652396.
  64. ^ Béraud G, Pierre-François S, Foltzer A, Abel S, Liautaud B, Smadja D, et al. (April 2009). "Cotrimoxazole for treatment of cerebral toxoplasmosis: an observational cohort study during 1994-2006". The American Journal of Tropical Medicine and Hygiene. 80 (4): 583–587. doi:10.4269/ajtmh.2009.80.583. PMID 19346380. S2CID 22240685.
  65. ^ Alavi SM, Alavi L (September 2010). "Treatment of toxoplasmic lymphadenitis with co-trimoxazole: double-blind, randomized clinical trial". International Journal of Infectious Diseases. 14 (Supplement 3): e67–e69. doi:10.1016/j.ijid.2009.11.015. PMID 20194044.
  66. ^ Patil HV, Patil VC, Rajmane V, Raje V (January 2011). "Successful treatment of cerebral toxoplasmosis with cotrimoxazole". Indian Journal of Sexually Transmitted Diseases and AIDS. 32 (1): 44–46. doi:10.4103/0253-7184.81255. PMC 3139289. PMID 21799577.
  67. ^ "Co-trimoxazole Medicinal forms". NICE. Retrieved 4 June 2024.
  68. ^ "Novo-Trimel Advanced Patient Information - Drugs.com". Drugs.com. Archived from the original on 1 February 2018. Retrieved 1 February 2018.
  69. ^ "Septran/Sepman Double Strength - Co-Trimoxazole Oral Formulations" (PDF). GlaxoSmithKline. 13 August 2017. Archived (PDF) from the original on 1 June 2018. Retrieved 1 June 2018.
  70. ^ "SEPTRIN FORTE Comp. 800/160 mg - Datos generales". Archived from the original on 16 June 2015. Retrieved 17 August 2015.