Bactrim

Adult Dosing .

Dosage forms:  TAB: 400 mg/80 mg

Dosage Forms Discontinued in US

[oral susp, IV not avail. as brand; see generic]

Special Note

[dosing clarification]

Info: dosing based on trimethoprim (TMP) component

infections, mild-moderate bacterial

[160 mg TMP PO bid]

Alt: 8-10 mg/kg/day TMP PO/IV divided q6-12h; Info: dose, duration varies w/ infection type, severity; consider using adjusted wt of IBW + 0.4 x (ABW - IBW) if >8 mg/kg/day in obese pts

UTI

[mild-moderate infection]

Dose: 160 mg TMP PO/IV q12h x3-14 days; Info: duration varies w/ infection type, severity; give x3 days if uncomplicated cystitis; refer to IDSA guidelines

[severe infection]

Dose: 8-10 mg/kg/day TMP IV divided q6-12h for up to 14 days; Alt: 8-10 mg/kg/day TMP PO divided q6-12h for up to 14 days; Info: dose, duration varies w/ infection type; give x14 days if pyelonephritis, may give w/ ceftriaxone or gentamicin; refer to IDSA guidelines; IV route preferred; consider using adjusted wt of IBW + 0.4 x (ABW - IBW) if >8 mg/kg/day in obese pts

PCP tx

[15-20 mg/kg/day TMP PO/IV divided q6-8h x21 days]

Info: consider using adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

PCP prophylaxis

[80-160 mg TMP PO qd]

Alt: 160 mg TMP PO 3x/wk

meningitis, bacterial (off-label)

[10-20 mg/kg/day TMP PO/IV divided q6-12h for at least 21 days]

Info: for Listeria monocytogenes; dose, duration varies w/ infection severity; not 1st-line tx; consider using adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

salmonellosis, acute (off-label)

[160 mg TMP PO bid]

Info: duration varies w/ infection severity; not 1st-line tx

salmonella, chronic carrier (off-label)

[160 mg TMP PO bid x3mo]

Info: not 1st-line tx

yersiniosis, severe (off-label)

[160 mg TMP PO bid]

Info: duration varies w/ infection severity

typhoid fever (off-label)

[160 mg TMP PO/IV q12h up to 14 days]

Info: for susceptible strains only

toxoplasmosis tx (off-label)

[10 mg/kg/day TMP PO/IV divided q12h for at least 6wk]

Info: duration varies w/ infection severity; not 1st-line tx; consider using adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts

toxoplasmosis prophylaxis, primary (off-label)

[160 mg TMP PO qd]

Alt: 80 mg TMP PO qd; 160 mg TMP PO 3x/wk; Info: refer to NIH HIV opportunistic infection guideline for tx duration

toxoplasmosis prophylaxis, secondary (off-label)

[160 mg TMP PO bid]

Alt: 160 mg TMP PO qd; Info: not 1st-line agent; refer to NIH HIV opportunistic infection guideline for tx duration

pertussis (off-label)

[160 mg TMP PO bid x14 days]

granuloma inguinale (off-label)

[160 mg TMP PO bid for at least 3wk]

Info: may extend tx if not healed after 3wk; not 1st-line agent

cyclosporiasis (off-label)

[160 mg TMP PO bid x7-10 days]

Info: for immunocompetent pts; may extend duration in HIV pts

renal dosing

[>10 mg/kg/day TMP regimen]

CrCl 10-30: 5 mg/kg/dose TMP q12h; CrCl <10: 5 mg/kg/dose TMP q24h

HD: 5 mg/kg/dose TMP q24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined

[2-3x/wk regimen]

renal impairment: not defined

HD/PD: not defined

[all other regimens]

CrCl 15-30: decr. usual dose by 50%; CrCl <15: avoid use

HD: 160 mg TMP x1, then decr. usual dose by 50%, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 160 mg TMP q24h; no supplement

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised; Info: contraindicated if significant impairment

Peds Dosing .

Dosage forms:  TAB: 400 mg/80 mg

Dosage Forms Discontinued in US

[oral susp, IV not avail. as brand; see generic]

Special Note

[dosing clarification]

Info: dosing based on trimethoprim (TMP) component

infections, mild-moderate bacterial

[2 mo and older]

Dose: 8-10 mg/kg/day TMP PO/IV divided q6-12h; Info: dose, duration varies w/ infection type, severity

PCP tx

[2 mo and older]

Dose: 15-20 mg/kg/day TMP PO/IV divided q6-8h x21 days

PCP prophylaxis

[1 mo-12 yo (off-label)]

Dose: 5-10 mg/kg/day TMP PO divided bid 2-3x/wk; Max: 320 mg/day TMP; Alt: 5-10 mg/kg/dose TMP PO qd; Info: may give on consecutive days or alternate days when given 2-3x/wk

[13 yo and older]

Dose: 80-160 mg TMP PO qd; Alt: 160 mg TMP PO 3x/wk

UTI tx

[2-23 mo]

Dose: 8-12 mg/kg/day TMP PO/IV divided q6-12h x7-14 days; Max: 320 mg/day TMP; Info: dose, duration varies w/ infection type, severity

[mild-moderate infection, 2 yo and older]

Dose: 8 mg/kg/day TMP PO/IV divided q12h x3-10 days; Max: 320 mg/day TMP; Info: duration varies w/ infection type, severity

[severe infection, 2 yo and older]

Dose: 8-10 mg/kg/day TMP IV divided q6-12h up to 14 days; Alt: 8-10 mg/kg/day TMP PO divided q6-12h up to 14 days; Info: dose, duration varies w/ infection type; IV route preferred

UTI prophylaxis (off-label)

[2 mo and older]

Dose: 2-4 mg/kg/dose TMP PO qd; Alt: 5 mg/kg/dose TMP PO 2x/wk

meningitis, bacterial (off-label)

[2 mo and older]

Dose: 10-20 mg/kg/day TMP PO/IV divided q6-12h for at least 21 days; Info: for Listeria monocytogenes; dose, duration varies w/ infection severity; not 1st-line tx

salmonellosis, acute (off-label)

[2 mo and older, <32 kg]

Dose: 10 mg/kg/day TMP PO divided bid; Info: duration varies w/ infection severity; not 1st-line tx

[2 mo and older, >32 kg]

Dose: 320 mg/day TMP PO divided bid; Info: duration varies w/ infection severity; not 1st-line tx

salmonella, chronic carrier (off-label)

[2 mo and older, <32 kg]

Dose: 10 mg/kg/day TMP PO divided bid x3mo; Info: not 1st-line tx

[2 mo and older, >32 kg]

Dose: 320 mg/day TMP PO divided bid x3mo; Info: not 1st-line tx

yersiniosis, severe (off-label)

[2 mo and older, <32 kg]

Dose: 10 mg/kg/day TMP PO divided bid; Info: duration varies w/ infection severity

[2 mo and older, >32 kg]

Dose: 320 mg/day TMP PO divided bid; Info: duration varies w/ infection severity

typhoid fever (off-label)

[2 mo and older]

Dose: 8 mg/kg/day TMP PO/IV divided q6-12h up to 14 days; Max: 320 mg/day TMP; Info: for susceptible strains only

toxoplasmosis tx (off-label)

[13 yo and older]

Dose: 10 mg/kg/day TMP PO/IV divided q12h for at least 6wk; Info: duration varies w/ infection severity; not 1st-line tx

toxoplasmosis prophylaxis, primary (off-label)

[1 mo-12 yo]

Dose: 150 mg/m^2/day TMP PO qd; Max: 160 mg/day TMP; Info: refer to NIH HIV opportunistic infection guideline for tx duration

[13 yo and older]

Dose: 160 mg TMP PO qd; Alt: 80 mg TMP PO qd; 160 mg TMP PO 3x/wk; Info: refer to NIH HIV opportunistic infection guideline for tx duration

toxoplasmosis prophylaxis, secondary (off-label)

[1 mo-12 yo]

Dose: 150 mg/m^2/dose TMP PO qd; Max: 320 mg/day TMP; Info: not 1st-line agent; refer to NIH HIV opportunistic infection guideline for tx duration

[13 yo and older]

Dose: 160 mg TMP PO bid; Alt: 160 mg TMP PO qd; Info: not 1st-line agent; refer to NIH HIV opportunistic infection guideline for tx duration

pertussis (off-label)

[2 mo and older]

Dose: 8 mg/kg/day TMP PO divided bid x14 days

granuloma inguinale (off-label)

[adolescents]

Dose: 160 mg TMP PO bid for at least 3wk; Info: may extend tx if not healed after 3wk; not 1st-line agent

brucellosis (off-label)

[1 mo-7 yo]

Dose: 8-10 mg/kg/day TMP PO divided bid x6wk; Max: 480 mg/day TMP; Info: part of multi-drug regimen

renal dosing

[2-3x/wk regimen]

renal impairment: not defined

HD/PD: not defined

[all other regimens]

CrCl 15-30: decr. usual dose by 50%; CrCl <15: avoid use per pkg insert, Alt: 5-10 mg/kg/dose TMP q24h

HD: avoid use; Alt: 5-10 mg/kg/dose TMP q24h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: avoid use; Alt: 5-10 mg/kg/dose TMP q24h; no supplement

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised; Info: contraindicated if significant impairment