Sulphamethoxazole 400 mg + Trimethoprim 80 mg Inj
Trade Name
Prescriber Category
:
:
Bactrim
UKK
(A)
Department
Antimicrobial Restriction
:
:
Green Category
INDICATION (BLUE BOOK / UKK)
(1) Severe or complicated infections when oral therapy is not feasible. (2) Treatment and prophylaxis of PCP in immunocompromised patients.
DOSING FOR ADULTS GUIDE [DIAMS HSgB]
1. PCP Treatment:
15-20 mg/kg (TMP) IV or PO per day (divided into 3-4 doses)
2. PCP Prophylaxis (CD4 <400):
TMP 80 mg/ SMX 400 mg (1 tablet) PO q24h
3. Toxoplasmosis Encephalitis (TE) Treatment:
5 mg/kg (TMP) IV or PO q12h
4. Toxoplasmosis Encephalitis (TE) Maintenance Therapy:
TMP 160 mg/ SMX 800 mg (2 tablets) PO q12h
5. Toxoplasmosis Encephalitis (TE) Primary Prophylaxis (CD4 <100):
TMP 160 mg/ SMX 800 mg (2 tablets) PO q24h
6. MSSA / MRSA Skin & Soft Tissue (SSTI) or MSSA / MRSA Bone & Joint Infection:
(Combination therapy)
8 - 12 mg/kg/day (TMP) IV or PO in 2 divided doses
7. MSSA / MRSA Bacteremia:
10-15 mg/kg/day (TMP) IV in 2 divided doses
8. Salmonellosis (non-thyphi):
5 mg/kg (TMP) IV or PO q12h
9. Stenotrophomonas maltophilia:
15-20 mg/kg day (TMP) IV in 3-4 divided doses
10. Melioidosis (weight bases dosing):
<40 kg: TMP 160 mg / SMX 800 mg (2 tablets) PO q12h
40-60 kg: TMP 240 mg / SMX 1200mg (3 tablets) PO q12h
>60 kg: TMP 320 mg / SMX 1600 mg (4 tablets) PO q12h
RENAL DOSE ADJUSTMENT IN ADULTS GUIDE [DIAMS HSgB]
For PCP Treatment:
15-30 ml/min:
5 mg/kg (TMP) IV or PO q12h
<15 ml/min or HD:
5 mg/kg (TMP) IV or PO q24h
Use with caution & appropriate monitoring or use alternative
[administer dose after HD on dialyisis day]
For PCP Prophylaxis (CD4 <200):
15-30 ml/min:
Reduce dose by 50%
<15 ml/min or HD:
Reduce dose by 50%
Use with caution & appropriate monitoring or use alternative
[administer dose after HD on dialyisis day]
For Toxoplasmosis Encephalitis (TE) Treatment:
15-30 ml/min:
5 mg/kg (TMP) IV or PO q24h
<15 ml/min or HD:
5 mg/kg (TMP) IV or PO q24h [administer dose after HD on dialyisis day] Use with caution & appropriate monitoring or use alternative
For Toxoplasmosis Encephalitis (TE) Maintenance Therapy & Primary Prophylaxis (CD4 <100):
15-30 ml/min:
Reduce dose by 50%
<15 ml/min or HD:
Reduce dose by 50%
Use with caution & appropriate monitoring or use alternative
[administer dose after HD on dialyisis day]
For indications below, choose renal dose based on normal total daily dose of TMP
1. MRSA / MSSA SSTI or Bone & Joint Infection (Combination Therapy)
2. MRSA / MSSA Bacteremia
3. Salmonellosis (non-thyphi)
4. Stenotrophomonas maltophilia infection
Total daily dose TMP 10 mg/kg/day:
15-30 ml/min:
5 mg/kg (TMP) IV or PO in q24h
<15 ml/min or HD:
2.5 - 5 mg/kg (TMP) IV or PO q24h [Administer dose after HD on dialysis day] Use with caution & appropriate monitoring or use alternative
Total daily dose TMP 8 -12 mg/kg/day:
15-30 ml/min:
4 - 6 mg/kg (TMP) IV or PO in 2 divided doses
<15 ml/min or HD:
2 - 3 mg/kg (TMP) IV or PO q24h
or
4 - 6 mg/kg (TMP) IV or PO q24-48h [Administer dose after HD on dialysis day] Use with caution & appropriate monitoring or use alternative
Total daily dose TMP 15 - 20 mg/kg/day:
15-30 ml/min:
7.5 - 10 mg/kg (TMP) IV or PO in 2 - 4 divided doses
<15 ml/min or HD:
4 - 5 mg/kg (TMP) IV or PO q24h
or
7.5 - 10 mg/kg (TMP) IV or PO q24-48h [Administer dose after HD on dialysis day] Use with caution & appropriate monitoring or use alternative
For Melioidosis:
15 - 30 ml/min:
Usual dose q24h
<15 ml/min or HD:
Usual dose q24h [Administer dose after HD on dialysis day]
IV TO PO GUIDE [DIAMS HSgB]
Equivalent to IV dose
EXTENDED INFUSION GUIDE [DIAMS HSgB]
In-progress
SPECIAL MONITORING & PRECAUTION GUIDE [DIAMS HSgB]
In-progress
ALTERNATIVE DOSING (BLUE BOOK / HSgB DRUG LIST)
(1) Adult: 960 mg bd increased to 1.44 g bd in severe infections. Child: 36 mg/kg dly in 2 divided doses increased to 54 mg/kg/day in severe infections. (2) Treatment: Adult & Child > 4 wks: 120 mg/kg/day PO/IV infusion in 2-4 divided doses for 14 days. Prophylaxis: Adult: 960 mg od or 960 mg on alternate days (3 times a wk) or 960 mg bd on alternate days (3 times a wk). Child: 6 wks-5 mths: 120 mg bd on 3 consecutive days or 7 days per wk; 6 mths-5 yrs: 240 mg; 6-12 yrs: 480 mg.