Cotrimoxazole trimethoprim

Cotrimoxazole (trimethoprim-sulfamethoxazole) or trimethoprim alone may be nsed for treating patients who do not tolerate tetracycline and erythromycin or in cases of resistance to these antibiotics. The adnlt dosage is usually 800 mg sulfamethoxazole and 160 mg trimethoprim twice daily. 

Amsden GW, Foulds G, Thakker K. Pharmacokinetic study of azithromycin with fluconazole and cotrimoxazole (trimethoprim-sulfamethoxazole) in healthy volunteers. Clin Drug Invest... 

The sulfa dmgs are stiH important as antimicrobials, although they have been replaced in many systemic infections by the natural and semisynthetic antibiotics. They are of great value in third world countries where problems of storage and lack of medical personnel make appropriate use of antibiotics difficult. They are especially useful in urinary tract infections, particularly the combination of sulfamethoxazole with trimethoprim. Their effectiveness has been enhanced by co-adniinistration with dihydrofolate reductase inhibitors, and the combination of sulfamethoxazole with trimethoprim is of value in treatment of a number of specific microbial infections. The introduction of this combination (cotrimoxazole) in the late 1960s (1973 in the United States) resulted in increased use of sulfonamides. 

Anti-Pneumocystis Prophylaxis Sulfamethoxazole-trimethoprim (SMZ-TMP, cotrimoxazole) One SS tablet by mouth once a day3 One DS tablet by mouth once a day3 One DS tablet by mouth every MA/V/F3 Hyperkalemia Myelosuppression Nephrotoxicity Neutropenia Photosensitivity Rash... 

Cotrimoxazole contains the synergstic antibiotics sulfamethoxazole and trimethoprim, which inhibit different steps in the prokaryotic synthesis of tetrahydrofolate. 

The diaminopyrimidines trimethoprim and pyrimethamine are synthetic, antibacterial drags and inhibitors of dihydrofolate reductase that are used both independently as well as in combination with sulfanilamides, in particular, with sulfamethoxazole (cotrimoxazole, bactrim, biseptol, sulfatrim, and many others). 

Wing LM, Miners JO. Cotrimoxazole as an inhibitor of oxidative drug metabolism effects of trimethoprim and sulphamethoxazole separately and combined on tolbutamide disposition. Br J Clin Pharmacol 1985 20(5) 482-5. 

BASF Hefa, PIJREN ratiopharm Hexal)-comb. with trimethoprim Cotrim-Diolan/-fortc (Engelhard)-comb. with trimethoprim Cotrim-EuRho (Eu Rho Arznei)-comb. with trimethoprim Cotrimoxazol (Aluid Pharma)-comb. with trimethoprim F ... 

Cotrimoxazol/-forte (Fatol)-eomb. with trimethoprim Cotriniox-Wolff (WolfQ-comb. with trimethoprim... 

It is important to consider the influence of interaction between functional groups of drugs that leads to their habit modification when formulated in suspension dosage form. Proton transfer from the N atom of sulfamethoxazole to the pyrimidine basic N1 atom of trimethoprim has been reported to occur in their equimolar complexes. Bettinetti et al. have reported nucleation of the complex of trimethoprim and sulfa-methoxypyridazine (1 1) to be accelerated by water or wet granulation. Our studies on cotrimoxazole (unpublished results) revealed immediate formation of fine needle-shaped crystals irrespective of the initial shape of sulfamethoxazole and trimethoprim crystals as a result of the interaction between the two drugs in suspension form. Small needles (Fig. 6A) were... 

The synergistic combination of trimethoprim (TMP), and sulfamethoxazole (SMZ), both folic acid antagonist antibacterial agents, was introduced over 30 years ago for its effect against a variety of infective organisms, including Pneumocystis carinii (PC). Prior to the AIDS era, TMP-SMZ, also referred as cotrimoxazole, was used predominantly for the... 

Treatment of Pneumocystis carinii pneumonia with agents such as trimethoprim-sulfamethoxazole (or cotrimoxazole) or parenteral pentamidine is associated with a 60% to 1 00% response rate. Trimethoprim-sulfamethoxazole is the regimen of choice for the treatment and prophylaxis of PCP patients with and without HIV because it is less toxic. 

Sulfamethoxazole-Trimethoprim Cotrimoxazole (Bactrim, Septra, Cotrim)... 

According to Sheehan (1981), at present cotrimoxazole is the most frequent cause of agranulocytosis in which there is a toxicity for the bone marrow, effected by the sulfonamide as well as by the trimethoprim (Lawson and Henry 1977 Inman 1977 Evans and Tell 1969 Lasson 1977 Chanu et al. 1981). Bone et al. (1981) and Stimmesse et al. (1979) report cases of lethal pancytopenia after cotrimoxazole, Thorel et al. (1981) and Claas et al. (1979) acute thrombocytopenia. 

Wahlin and Rosman (1976) observed eight cases of serious skin and general reactions within 18 months after cotrimoxazole which were based on allergic reactions. Braun-Falco et al. (1978) observed pustulosis acuta generalisata with distinct leukocytoclastic vasculitis in the upper corium in a 52-year-old woman who was treated with trimethoprim/sulfamethoxazole for acute bronchitis. 

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