Indications
Cotrimoxazole exhibits bactericidal activity against a broad spectrum of bacteria, including Gram-positive and Gram-negative organisms such as Streptococcus, Staphylococcus, Escherichia coli, and Haemophilus influenzae. It is particularly effective in treating conditions like chronic bronchitis and urinary tract infections. Cotrimoxazole works by blocking bacterial enzymes involved in Folinic acid biosynthesis, which enhances its bactericidal potency.
Indicated for:
- Respiratory tract infections (acute and chronic bronchitis, pneumonia)
- Genitourinary tract infections (cystitis, pyelonephritis)
- Gastrointestinal infections (Salmonella spp.)
- Other infections where susceptible organisms are confirmed, including osteomyelitis, skin infections, and septicemia.
Pharmacology
Cotrimoxazole, containing Trimethoprim and Sulphamethoxazole in a 1:5 ratio, acts against a wide range of bacteria and some protozoa. It inhibits bacterial Folinic acid production through sequential enzyme blockade.
Dosage & Administration
Dosage varies by age and severity:
- Adults: For mild to moderate infections, typically 1-2 tablets twice daily. Adjustments are made for severe infections and long-term therapy.
Contraindications
Avoid in patients with hypersensitivity to trimethoprim or sulphonamides, megaloblastic anemia due to folate deficiency, severe liver or kidney impairment, or glucose 6-phosphate dehydrogenase deficiency.
Side Effects
Rare side effects may include crystalluria, allergic reactions, and blood disorders. Common, less severe effects include malaise, headache, nausea, and vomiting, usually transient and manageable without discontinuation.
Pregnancy & Lactation
Cotrimoxazole should be avoided during pregnancy and breastfeeding due to potential risks to the baby, including kernicterus.
Precautions & Warnings
Extended use may lead to macrocytic anemia; monitor patients, especially those with diabetes taking sulphonylureas. Provide Folinic acid if necessary.
Therapeutic Class
Cotrimoxazole belongs to the class of antimicrobial drugs known as sulphonamides and trimethoprim combinations.
Storage Conditions
Store below 30°C, protected from light and moisture, and keep out of reach of children.
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