Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim, Septra) can be used as treat a variety of infections in children.
Infections for which TMP-SMX may be considered:
(1) urinary tract infections
(2) acute otitis media
(4) acute sinusitis
Oral formulations for TMP-SMX (in fixed dose ratio of 1 to 5):
(1) single strength tablet (80 mg TMP, 400 mg SMX)
(2) double strength tablet (DS, 160 mg TMP, 800 mg SMX)
(3) suspension (8 mg TMP per mL, 40 mg SMX per mL)
TMP-SMX is contraindicated in infants < 2 months old because of the risk for kernicterus.
For acute bacterial infections dosing is 8 mg/kg TMP and 40 mg/kg SMX per day.
The daily dose is divided for q12h po administration. This means that 4 mg/kg TMP and 20 mg/kg SMX are given twice a day.
Duration of therapy is usually for 10 days.
If tablets are given the following table can be used for the high end of the dosage range:
Body Weight in Kg
Single Strength Tablet po q12h
Double Strength Tablet po q12h
If renal function is impaired, then the dose should be reduced.
> 30 mL per min
15 - 30 mL per min
reduce by 50%
< 15 mL per min
use alternative therapy
For the creatinine clearance of 15 - 30 mL this works out to the following:
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Specialty: Infectious Diseases, Urology, Pharmacology, clinical