Co-Trimoxazole (Bactrim) Drug Study

Generic name: Co-trimoxazole (trimethoprim sulfamethoxazole)

Brand name: Septra (GSK), Bactrim (Roche)

Drug class: Sulfonamide antibiotic

Actions

Trimethoprim inhibits the synthesis of nucleic acids and proteins in susceptible bacteria; the bacterial enzyme involved in this reaction is more readily inhibited than the mammalian enzyme.

Sulfamethoxazole acts as a false-substrate inhibitor of dihydropteroate synthetase. Sulfonamides such as sulfamethoxazole are analogues of p-aminobenzoic acid (PABA) and are competitive inhibitors of the enzyme; inhibiting the production of dihydropteroic acid.

Indications

• Uncomplicated UTIs caused by susceptible strains of Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter species, and coagulase-negative Staphylococcus species, including S. Saprophyticus.
• Treatment of acute otitis media due to susceptible strains of S. Pneumoniae and Haemophilus influenzae in children.
• Unlabeled uses: With dapsone for treatment of initial episodes of Pneumocystis jiroveci (carinii) pneumonia in patients who can tolerate co-trimoxazole; treatment and prevention of traveller’s diarrhea.

Contraindications

• Contraindicated with allergy to trimethoprim and sulfamethoxazole, pregnancy (teratogenic in pre-clinical studies), megaloblastic anemia due to folate deficiency.
• Use cautiously with hepatic or renal impairment, lactation.

Available forms

Tablets – 100, 200 mg

Side Effects

• Rash
• Pruritus
• Fever
• Epigastric distress
• Nausea
• Vomiting

Nursing considerations

• Perform culture and sensitivity tests before beginning drug therapy.
• Protect the 200mg tablets from exposure to light.
• Arrange for regular, periodic blood counts during therapy.
• Discontinue drug and consult with physician if any significant reduction in any formed blood element occurs.

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