Co-trimoxazole

= sulphamethoxazole + trimethoprim.

• Usual adult treatment dose: 30mg/kg/ QDS

• Usual adult prophylaxis dose: up to 960mg bd, 3 times per week.

• Can be given IV or orally

• Renally excreted therefore reduce dose if renal impairment.

• Reserved for the treatment and prevention of PCP and toxoplasmosis due to serious adverse effects (Stevens-Johnson syndrome, blood dyscrasias).

• Penetrates well into CSF and tissue.

Indications:

• PCP – treatment and prophylaxis

• Toxoplasmosis – treatment and prophylaxis

• Spontaneous Bacterial Peritonitis - treatment and prophylaxis

• Antibiotic prophylaxis for patients with liver cirrhosis and an upper gastrointestinal bleed

Active against most strains of:

• Pneumocystis carinii

• Nocardia

• Staphylococcus aureus – including MRSA
• Escherichia coli 

• Klebsiella spp

• Other Coliforms
• Moraxella
• Haemophilus
• Stenotrophomonas maltophilia
• Listeria

Not active against most strains of:

• Anaerobes

• Strep pneumoniae

Page last edited: 09/02/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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