In patients with an allergy to penicillin a safe approach would be to use a different class of antibiotic altogether. In true penicillin-allergic patients Bactrim DS could be considered.

Bactrim (sulfamethoxazole and trimethoprim) is a combination of two antibiotics, sulfamethoxazole and trimethoprim.

Supplied:  Bactrim is available in tablets in two strengths; 400 mg sulfamethoxazole and 80 mg trimethoprim and the “DS” form which means double strength, 800 mg sulfamethoxazole and 160 mg trimethoprim.

Bactrim is available as a generic drug under assorted names (for example, sulfamethoxazole and trimethoprim, co-trimoxazole)

How we use it: The most common reason we prescribe an oral antibiotic (like Bactrim) is for the treatment of moderate to advanced internal hordeola (stye), and always in concert with the aggressive use of warm soaks.    It is especially useful because it is an effective drug for aggressive Staph infections (e.g.MRSA).

Dose:  For treatment of bacterial infections:

  • Adults and children 40 kilograms (kg) of body weight or more—800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim every 12 hours. (two double strength tablets twice a day for 1 week).
  • Infants 2 months of age and older, and children up to 40 kg of weight—Dose is based on body weight. The usual dose is 40 mg of sulfamethoxazole and 8 mg of trimethoprim per kg of body weight every 12 hours.

Bactrim comes in tablet form. It is usually taken by mouth, usually twice a day. You can take this medication with food or on an empty stomach. If it bothers your stomach, try taking it with food.

Bactrim can be taken at any time of the day; however, be sure to take the medication at the same time(s) each day. For instance, if you take it twice daily, it is best to evenly space the doses, taking a dose every 12 hours.

Children: BACTRIM is contraindicated in pediatric patients less than 2 months of age.

Pregnancy: (Category C) Because sulfamethoxazole and trimethoprim may interfere with folic acid metabolism, Bactrim should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Side Effects: The most common adverse effects are gastrointestinal disturbances (nausea, vomiting) and allergic skin reactions (such as rash and itching).

Warnings:  For a more complete discussion of precautions and warnings click here

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