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Sutrim

Sutrim (generic name: Co-trimoxazole; brand names include: Septra / Ciplin / Septrin) is a combination of two antibiotics (trimethoprim and sulfamethoxazole) used to treat a wide variety of bacterial infections.

Other names for this medication:
Bactiver, Bactrim, Bactron, Baktar, Balkatrin, Biotrim, Biseptol, Ciplin, Cotrim, Cozole, Deprim, Ditrim, Gantrisin, Globaxol, Kemoprim, Lagatrim, Primadex, Purbac, Resprim, Sanprima, Sepmax, Septra, Septran, Septrin, Soltrim, Sulfa, Sulfamethoxazole, Sulfametoxazol, Sulfatrim, Sumetrolim, Supreme, Tagremin, Trifen, Trimoks, Trimol, Vanadyl

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Also known as:  Bactrim.

Description

Sulfamethoxazole and trimethoprim combination is used to treat infections such as urinary tract infections, middle ear infections (otitis media), bronchitis, traveler's diarrhea, and shigellosis (bacillary dysentery). This medicine is also used to prevent or treat Pneumocystis jiroveci pneumonia or Pneumocystis carinii pneumonia (PCP), a very serious kind of pneumonia. This type of pneumonia occurs more commonly in patients whose immune systems are not working normally, such as cancer patients, transplant patients, and patients with acquired immune deficiency syndrome (AIDS).

Sulfamethoxazole and trimethoprim combination is an antibiotic. It works by eliminating the bacteria that cause many kinds of infections. This medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Dosage

Prescribing Sutrim (sulfamethoxazole and trimethoprim) tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Sutrim should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency (e.g., the elderly, chronic alcoholics, patients receiving anticonvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states) and to those with severe allergies or bronchial asthma.

Hematological changes indicative of folic acid deficiency may occur in elderly patients or in patients with preexisting folic acid deficiency or kidney failure. These effects are reversible by folinic acid therapy.

Overdose

Often, no treatment is needed for an antibiotic overdose. Usually, you'll need to watch for stomach upset and possibly diarrhea. In those cases, you should give extra fluids.

Storage

Store at room temperature between 20 to 25 degrees C (68 to 77 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Sutrim are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Sutrim is contraindicated in patients with a known hypersensitivity to trimethoprim or sulfonamides, in patients with a history of drug-induced immune thrombocytopenia with use of trimethoprim and/or sulfonamides, and in patients with documented megaloblastic anemia due to folate deficiency.

Sutrim is contraindicated in pediatric patients less than 2 months of age. Sutrim is also contraindicated in patients with marked hepatic damage or with severe renal insufficiency when renal function status cannot be monitored.

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Retrospective cohort study.

sutrim drug

In summary, recent advances in our ability to diagnose, treat, and prevent recurrences of pneumocystis pneumonia have significantly improved the clinical management of this infection, especially in HIV-1-infected individuals. As current investigations allow our therapeutic armamentarium in this disease to be strengthened even further, it is likely that pneumocystis pneumonia will pose a diminishing threat to those patients currently most susceptible to this infection.

sutrim dose

To better understand the epidemiology of bacterial pathogens with particular public health importance in Taiwan, we determined the prevalence of nasal colonization with methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in a cohort of HIV-infected patients attending two hospital outpatient departments. All HIV-infected patients followed regularly between May and September 1999 were enrolled and cultures of the anterior nares were performed using a dry sponge swab. All confirmed S. aureus isolates underwent antimicrobial susceptibility testing using disk diffusion according to recommendations of the National Committee for Clinical Laboratory Standards. Of a total of 162 outpatients studied, 48 (30%) were found colonized with S. aureus including 39 (24%) colonized with MSSA and 9 (6%) colonized with MRSA. The only factor associated with MSSA colonization was receipt of trimethoprim-sulphamethoxazole which appeared protective (relative risk 0.4, 95% confidence interval [CI(95)] 0.2-0.78, P = 0.006). In contrast, ciprofloxacin use was an independent risk factor for MRSA colonization (conditional odds ratio [OR] 11.9, CI(95) 1.8-77.8, P = 0.010) along with a one-quartile reduction in CD(4) count (OR 3.9, CI(95) 1.1-14.3, P = 0.04). Although MRSA colonization was not associated with hospitalization within the previous three months, the multi-drug resistance pattern of MRSA isolates suggests strains were at some point acquired in the healthcare setting. Our study shows that the rate of S. aureus colonization in Taiwanese HIV-infected outpatients is 30%. Low CD4+ counts are most likely associated with other unmeasured risk factors for MRSA. Antimicrobial use may function alternatively as a protective or risk factor for colonization with S. aureus, depending upon the drugs involved and resistance encountered. Fluoroquinolone use may have an important role in the spread of MRSA from inpatient to outpatient settings.

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In this U.S. study, most MRSA isolates in the pediatric CF population were SCCmec II PVL negative. Rates of resistance were low, including to older and orally available antibiotics such as trimethoprim-sulfamethoxazole.

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Three cases diagnosed in a Pneumology Section are reported. None of them was affected by AIDS and all of them were initially diagnosed from bronchopneumonia. Empirical antibiotherapy was initiated and because of the unsatisfactory progress, bronchoscopy was performed in all cases and in one case a transthoracic puncture was made. Nocardia spp. was then isolated and this let to began with a specific treatment. All the patients progress satisfactorily in their respiratory infection.

sutrim syrup

Acute generalized exanthematous pustulosis is a severe eruption which is usually drug related. If the causative drug is discontinued, acute generalized exanthematous pustulosis resolves spontaneously in ten days. The aim of this study was to compare drugs suspected of causing acute generalized exanthematous pustulosis reported to French Pharmacovigilance centres and those reported in the literature.

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Some bacteria that possess chromosomally determined AmpC β-lactamases may express these enzymes at a high level following exposure to β-lactams, either by induction or selection for derepressed mutants. This may lead to clinical failure even if an isolate initially tests susceptible in vitro, a phenomenon best characterised by third-generation cephalosporin therapy for Enterobacter bacteraemia or meningitis. Several other Enterobacteriaceae, such as Serratia marcescens, Citrobacter freundii, Providencia spp. and Morganella morganii (often termed the 'ESCPM' group), may also express high levels of AmpC. However, the risk of clinical failure with β-lactams that test susceptible in vitro is less clear in these species than for Enterobacter. Laboratories frequently do not report β-lactam or β-lactamase inhibitor combination drug susceptibilities for ESCPM organisms, encouraging alternative therapy with quinolones, aminoglycosides or carbapenems. However, quinolones and carbapenems present problems with selective pressure for multiresistant organisms, and aminoglycosides with potential toxicity. The risk of emergent AmpC-mediated resistance for non-Enterobacter spp. appears rare in clinical studies. Piperacillin/tazobactam may remain effective and may be less selective for AmpC derepressed mutants than cephalosporins. The potential roles for agents such as cefepime or trimethoprim/sulfamethoxazole are also discussed. Clinical studies that better define optimal treatment for this group of bacteria are required.

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Prophylaxis with TMP-SMZ, which is well tolerated, significantly reduces the incidence of bacterial infection following renal transplantation, especially infection of the urinary tract and bloodstream, can provide protection against Pneumocystis carinii pneumonia, and is cost-beneficial. Subnormal absorption of TMP-SMZ in the early posttransplant period mandates 320/1,600 mg daily for optimal benefit. Prophylaxis has little discernible effect on the microflora.

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Although liver injury after administration of the trimethoprim-sulfamethoxazole combination is rare, hepatocellular necrosis and cholestasis have developed in a few cases. We describe a patient who developed a severe, prolonged cholestatic reaction after trimethoprim-sulfamethoxazole administration. The findings from serial liver biopsy samples showed characteristic abnormalities of phospholipidosis that have not been previously described for trimethoprim-sulfamethoxazole-related hepatic injury. The most prominent finding on electron microscopic evaluation of the liver was the presence of prominent hepatocyte lysosomal inclusions characterized by concentric arrangements of membranous and lamellated structures. The patient improved after several courses of exchange plasmapheresis, which may have assisted in the removal of toxic drug-lipid complexes. The pathogenesis of this acquired secondary phospholipidosis is unknown. Possible mechanisms include generation of highly lipid-soluble metabolites and inhibition of the lysosomal enzyme phospholipase A1.

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Patients with diarrhea due to strains of enterohemorrhagic Escherichia coli (EHEC) (e. g. O157:H7) might be at a higher risk of developing hemolytic uremic syndrome when treated with antimicrobial agents. It has been suggested that this might be due to an increase of release or production of vero or shiga-like toxin from such organisms, possibly as a stress response to antimicrobial agents. The aim of this study was to detect such increases in extracellular toxin in vitro with a newly developed method that exposed EHEC to high sublethal concentrations followed by a recovery phase at progressively lower concentrations. Five strains of EHEC were exposed to continuously changing concentrations of ciprofloxacin, co-trimoxazole, cefixime and tetracycline. The amount of free shiga-like toxin I (SLT-I) released was compared to the amount released from inocula that were not exposed to antibiotics. There were significant differences between the five EHEC strains in the amount of toxin detected after exposure to antimicrobial agents (p less than 0.001). Equally important was the type of antibiotic (p less than 0.001), with ciprofloxacin inducing the largest increase ranging from 169 to 436%, followed by co-trimoxazole, cefixime and tetracycline. In addition, the increases in free toxin correlated with the concentration of the antibiotics (p less than 0.001). The association between antibiotic-induced increases in SLT-I produced by strains of EHEC and certain classes of antibiotics might influence the analysis of future epidemiological studies on risk factors for HUS.

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The patients were divided into three groups, each consisting of 17 patients: group 1: a single-dose of piperacillin / tazobactam 4.5 g i. v., group 2: ciprofloxacin 500 mg or cotrimoxazol 960 mg i. v. / p. o. and group 3: varying administration and duration of different kinds of antibiotics as control group. The basic characteristics of the patients such as age, body-mass-index, risk factors, diseases, former surgeries and medication were similar between all three groups. Also there were no significant differences in intraoperative parameters such as operation time, blood loss and other postoperative complications.

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We have examined the resistance of Pseudomonas pseudomallei biofilm cells to ceftazidime and cotrimoxazole. A large number of these biofilm cells remained viable at 12 and at 24 h, except in the biofilm treated with 200 times the MIC of ceftazidime. The inherent resistance of P. pseudomallei biofilms to conventional antibiotics may explain the lack of success in the treatment of the chronic manifestations of this bacterial infection.

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sutrim forte dose 2017-04-20

A meta-analysis overviewed 35 randomized trials comparing different regimens for P Uroflox Tablet carinii prophylaxis directly or with placebo. Analyses were based on intention-to-treat. On-treatment data were also analyzed when available.

sutrim dose 2016-07-11

One hundred forty-seven students from the Novamox Cv 625 Dosage United States were given trimethoprim-sulfamethoxazole (TMP-SMZ; 160 mg of TMP and 800 mg of SMZ) twice daily for 21 days after their arrival in Mexico. They were watched for the development of diarrhea during the 21 days and for an additional eight days after the termination of TMP-SMZ therapy. Diarrheal illness occurred in 11 (16%) of 67 students taking TMP-SMZ and in 44 (55%) of 80 students receiving a placebo; the differences were significant (P less than 0.001). Milder symptoms not quite satisfying the criteria for illness were also less common in the group receiving the active drug: 23% vs. 69% (P less than 0.001). The drug appeared to prevent infection by fully virulent enterotoxigenic Escherichia coli (strains producing heat-stable toxin and those producing heat-labile toxin) and perhaps by shigella strains. During the eight days of follow-up after drug administration, 14 students (26%) who had taken TMP-SMZ and two (2.5%) who had taken the placebo experienced diarrhea (P less than 0.05). Twelve subjects (14%) in the TMP-SMZ group and one subject (1%) in the placebo group developed a generalized rash that necessitated discontinuance of the drug. The eruption occurred after 9-16 days of drug administration (mean, 10 days). This study shows that TMP-SMZ taken twice daily can prevent travelers' diarrhea for up to three weeks. Diarrhea will develop, however, if the drug is stopped while the risk remains.

sutrim medicine 2015-07-23

References were obtained using MEDLINE Supreme Hats Order Online searches, the bibliographies of articles identified during the searches, review articles, and standard textbooks.

sutrim syrup 2016-04-29

During a 5 1/2-year period, 34 of 829 episodes of granulocytopenia during which broad spectrum antibiotics were being administered for fever and/or infections were complicated by the development of new pulmonary infiltrates. In 12 patients the infiltrates were due to fungal pneumonia, while in 6 patients the infiltrates were due to a variety of other causes. In the remaining 16 cases the etiology of Dose Of Azomax the infiltrates was not determined. Time to development of infiltrate, radiographic appearance of the infiltrate, patient temperature and absolute granulocyte count failed to predict the etiology of the infiltrate. Conversely, development of the infiltrate or its radiographic progression in the absence of bone marrow recovery correlated significantly with the diagnosis of fungal pneumonia. While empiric alterations of antibiotics at the time that the infiltrate appeared were not associated with improved survival, the early use of amphotericin B was associated with a significant decrease in fatal fungal pneumonia. We suggest that the diagnostic and therapeutic approach to the febrile, granulocytopenic patient who develops a new pulmonary infiltrate while receiving broad spectrum antibiotic therapy may be guided by the state of marrow recovery at the time of infiltrate appearance. Patients developing an infiltrate coincident with granulocyte recovery may be managed conservatively while patients whose infiltrate develops or progresses in the absence of granulocyte recovery should be considered to be at high risk for fungal pneumonia and if possible undergo a diagnostic lung biopsy and/or empiric antifungal therapy.

sutrim tablet 2015-04-30

We retrospectively reviewed the characteristics, clinical features, and prognosis Is Tricef Antibiotic of PCP in patients with CTD in a single hospital.

sutrim dose in neonates 2017-11-03

To examine the interaction between dapsone and Moxifloxacin 400 Mg Tablets trimethoprim in patients with the acquired immunodeficiency syndrome (AIDS).

dose of sutrim 2016-04-19

Prophylaxis against Pneumocystis carinii pneumonia is a logical management strategy for patient populations that have a high incidence of this infectious complication. Appropriate populations for consideration would include those with human immunodeficiency virus infection, recent recipients of bone marrow or solid organ transplants, children with acute lymphocytic leukemia, and adults with T cell leukemias. Trimethoprim-sulfamethoxazole given twice daily (2.5 mg of trimethoprim/kg and 12.5 Supplin 500 Mg Metronidazole mg of sulfamethoxazole/kg every 12 hours on three or seven consecutive days per week has been shown to be effective and well tolerated in some patient populations. Pyrimethamine-sulfadoxine given once weekly and aerosolized pentamidine given once or twice monthly are promising prophylactic agents that are currently undergoing closer scrutiny to determine their efficacy and safety.

sutrim syrup dose 2016-10-23

The optimal therapy for infections due to Nocardia species has not been established. To assess the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX), we reviewed the records of 19 patients with Nocardia infections seen at Duke University Medical Center, Durham, NC, who were treated with this drug, either alone or in combination with other antibiotics or a surgical procedure. Underlying diseases or therapy causing immunosuppression were present in all but five cases. Sites of involvement were lung (ten of 19), wound (two of 19), and brain (two of 19); five of 19 patients had disseminated disease. The mean duration of therapy was 7.2 months. Overall cure or improvement was Is Klerimed An Antibiotic achieved in 89% (17/19) of cases; 80% of patients with disseminated disease and 60% of those with CNS involvement recovered. This experience, and accumulated clinical evidence in the literature, indicates that TMP-SMX should be considered the therapeutic drug of choice in infections due to Nocardia species.