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2. Recurrent urinary tract infection prophylaxis.
3. Pneumocystis jiroveci pneumonia, as the drug of first choice (15-20 mg TMP/kg/day; 75-100 mg/kg/day divided Q6H
IV). Rash or hematologic toxicity is common in patients with AIDS.
4. Pneumocystis jiroveci prophylaxis for transplant or HIV + (whose CD4 has ever been <200) patients.
5. Shigellosis, typhoid fever.
6. Enteropathogenic Escherichia coli infections.
7. Traveler's diarrhea treatment. Resistance has limited utility to infections acquired in Mexico only.
8. Stenotrophomonas maltophilia infections – drug of choice. Dose at 12-15 mg/kg/day of TMP component divided Q6-8H
9. Methicillin-resistant Staphylococcus aureus mild infections (excluding endocarditis and abscesses).
10. MRSA decolonization (eradication of nasal carriage) – in combination with rifampin. Topical mupirocin may also be
effective, but is more expensive. MRSA decolonization with rifampin should not be attempted routinely; the Infectious
Disease service should be consulted.
11. Selected nontuberculin mycobacterial infections (strains other than Mycobacterium tuberculosis), given as part of a
combination regimen.
12. Acute otitis media or sinusitis treatment when patient is intolerant to beta-lactams.
13. Step-down therapy for skin or respiratory infections with CA-MRSA.
Dose adjustment required for renal impairment. See renal dosing guideline on uconnect.
TMP/SMX may no longer be the drug of choice for cystitis due to growing resistance problems when the resistance rate
exceeds 15%. UWHC susceptibilities suggest that TMP/SMX has limited activity against coagulase-negative
staphylococci. TMP/SMX should NOT be used in patients with SLE because the sulfonamide component induces disease
flares. TMP/SMX is not recommended for use in infants less than 2 months old. TMP/SMX should not be used in
pregnancy near term. TMP/SMX may induce hyperkalemia when used in high doses for AIDS patients or in normal doses
in the elderly. TMP/SMX is the agent of choice for prophylaxis against P jiroveci in patients with AIDS or transplant
patients. NOTE: Each 10 mL of the injection contains 160 mg of trimethoprim and 800 mg of sulfamethoxazole. The
suspension contains 80 mg/400 mg per 10 mL. Oral bioavailability is 90-100%.
No longer being manufactured and there are no supplies.
For up-to-date information on the use of antiretrovirals, consult an HIV expert or
TRUVADA® -- see tenofovir/emtricitabine
UNASYN® - see ampicillin/sulbactam