Alternate Name(s):
Cotrimoxazole, Septra
Classification:
Antibiotic
Original Date:
January 2009
Revised Date:
January 2018
Indications:
- Treatment of infections caused by Stenotrophomonas maltophilia, unresponsive to other therapies.
Administration:
- IV intermittent infusion: over 60 minutes
- PO
Dosage:
Dosage recommendations are based on the trimethoprim component
IV/PO:
- 15 - 20 mg/kg/day divided Q6-8h
Dosage adjustment required in renal impairment. Refer to available references or clinical pharmacist for dosage adjustment
Side Effects:
- Dermatologic: skin rash, Stevens-Johnson (rare)
- Endocrine and metabolic: hyperkalemia, hypoglycemia (rare), hyponatremia
- GI: nausea and vomiting
- Hematologic: anemia, eosinophilia, leukopenia, neutropenia, thrombocytopenia
- Hepatic: cholestatic jaundice, hyperbilirubinemia, increased transaminases
- Local: irritation, pain, phlebitis
- Renal: increased blood urea nitrogen, increased serum creatinine
Parameters to Monitor:
- CBC
- Electrolytes
- BUN, creatinine
- Bilirubin
Reconstitution and Stability:
- Sulfamethoxazole 80 mg/mL and Trimethoprim 16 mg/mL
- Take 2.5 mL (40 mg of Trimethoprim) and add to 47.5 mL of D5W
- Final concentration: 0.8 mg/mL of Trimethoprim
Compatibility:
- Solutions Compatible: D5W
- Y-site Compatible: morphine
- Incompatible: dobutamine, fentanyl, midazolam
Notes:
- Avoid in infants < 1 month of age
- Contains benzyl alcohol
References:
- Lexicomp (Lexi-Drugs), Drug Information Handbook 23rd Ed. Hudson, Ohio, Lexi-Comp, Inc. 2014-2015
- Chen.J, Lau.E (Editors), Drug handbook and Formulary - The Hospital for Sick Children. Toronto; 2017