BACTRIM DS 10 S

About

Bactrim DS is a combination antibiotic comprising trimethoprim and sulfamethoxazole, which act synergistically to inhibit bacterial folic acid synthesis. Sulfamethoxazole, a sulfonamide, competitively inhibits dihydropteroate synthase, an enzyme crucial for the incorporation of para-aminobenzoic acid (PABA) into dihydrofolic acid. Trimethoprim then inhibits dihydrofolate reductase, the enzyme responsible for converting dihydrofolic acid to tetrahydrofolic acid. This sequential blockade of two essential steps in the folate pathway leads to a potent bactericidal effect against a broad spectrum of Gram-positive and Gram-negative bacteria. It is a highly effective treatment for various infections, including urinary tract infections, respiratory tract infections, and specific opportunistic infections like *Pneumocystis jirovecii* pneumonia.

Uses

• Treatment of urinary tract infections.
• Management of acute otitis media.
• Therapy for acute exacerbations of chronic bronchitis.
• Treatment of *Pneumocystis jirovecii* pneumonia (PCP).

Directions For Use

Take one tablet orally with a full glass of water, usually twice daily, as directed by your physician. Ensure adequate hydration to prevent crystalluria.

Benefits

• Synergistic bactericidal action.
• Broad spectrum of antibacterial activity.
• Effective against many resistant bacterial strains.
• Good tissue penetration.
• Useful in treating opportunistic infections.
• Available in various formulations.

Side Effects

• Nausea.
• Vomiting.
• Diarrhea.
• Skin rash (including severe reactions like SJS/TEN).
• Photosensitivity.
• Hyperkalemia.
• Hyponatremia.
• Bone marrow suppression (anemia, leukopenia).
• Crystalluria.
• Kidney stones.
• Liver enzyme elevation.

Safety Measures

• Alcohol - No direct contraindication, but alcohol may exacerbate gastrointestinal side effects. Ensure adequate hydration during treatment.
• Pregnancy - Contraindicated in the first trimester due to folate antagonism and in late pregnancy due to risk of kernicterus in the newborn.
• Breastfeeding - Generally not recommended, especially in premature infants or those with hyperbilirubinemia, due to risk of kernicterus.
• Liver - Use with caution in hepatic impairment; monitor liver function. Contraindicated in severe liver disease.
• Kidney - Contraindicated in severe renal impairment (CrCl <15 mL/min). Dosage adjustment is necessary for moderate impairment.
• Lung - Used to treat *Pneumocystis jirovecii* pneumonia. Caution in patients with severe asthma or G6PD deficiency.

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