BACTRIM © (trimethoprim /sulfamethoxazole)

Usual Dosing (Adults)

(IV):
8-10mg/kg/day divided q6-12h.
PCP: 15-20mg/kg/day in 3 or 4 divided doses.

(Oral): UTI: 1 DS tab (160mg TMP/800mg SMX) po q12h.

Renal Dosing

Package Insert

Patients who receive cotrimoxazole intravenously or orally and have impaired renal function should be dosed according to the following dosage schedule:

Creatinine Clearance Dosage (mL/min)
Above 30: Standard regimen
15-30: 1/2 standard regimen
Below 15: Not recommended

Non-PCP:
[>30 ml/min]: no change
[15-30]: 2.5 mg/kg q12h
[<15 ml/min]: not recommended by manufacturer.

Alternative (LESS SUPPORT):
2.5mg/kg q24h (Avoid if possible due to risk of crystalluria/ nephrolithiasis)

PCP:
[>30 ml/min]: no change
[15-30]: 5mg/kg q12h
[<15 ml/min]: not recommended by manufacturer.

Alternative (LESS SUPPORT):
5mg/kg q24h (Avoid if possible due to risk of crystalluria/ nephrolithiasis)

Hemodialysis:
Not recommended by manufacturer.
Alternative (LESS SUPPORT):
Oral: Avoid if possible. If unavoidable, give one SS/DS q24h.
IV: Avoid if possible. If unavoidable, give 5mg/kg q24h.

Micromedex

Guidelines for the administration of cotrimoxazole (based on the trimethoprim component) in patients with renal dysfunctions (Paap & Nahata, 1995; Paap & Nahata, 1989):

INDICATION/RENAL FUNCTION DOSE
PCP TREATMENT
CrCl > than 30 ml/min
15-20 mg/kg/day divided q6-8h
CrCl 15 to 30 ml/min
15-20 mg/kg/day divided q6-8h for 48h then 7-10 mg/kg/day divided q12h
CrCl < 15 ml/min
15-20 mg/kg/dose q48h (or 7-10 mg/kg/day divided q12-24h)
Hemodialysis
15-20 mg/kg/dose before dialysis and 7-10 mg/kg/dose after dialysis

PCP PROPHYLAXIS
CrCl > 30 ml/min
5 mg/kg q24h for 3 to 7 doses/week
CrCl 15 to 30 ml/min
5 mg/kg q24-48h for 3 to 7 doses/week
CrCl < 15 ml/min
5 mg/kg q48-72h
Hemodialysis
5 mg/kg after dialysis

OTHER INFECTIONS
CrCl greater than 30 ml/min
8-12 mg/kg/day divided q12h for 14 days then 4-6 mg/kg q24h
CrCl 15 to 30 ml/min
8-12 mg/kg/day divided q12h for 1-2 days then 4-6 mg/kg/day q24h
CrCl less than 15 ml/min
8-12 mg/kg/dose q48h (or 4-6 mg/kg/day divided q12-24h)
Hemodialysis
8-12 mg/kg/dose before dialysis and 4-6 mg/kg/dose after dialysis

Hemodialysis

See above

Disclaimer

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Read the disclaimer

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