What are the advantages from using a mixture of sulfamethoxazole and trimethoprim?

Comparative Study

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Trimethoprim-sulfamethoxazole and trimethoprim alone for prophylaxis of infection in granulocytopenic patients
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Why sulfamethoxazole and trimethoprim is given in combination?
What is the advantage of using a sulfa drug in combination with trimethoprim?
What is the rationale behind combination of trimethoprim and sulfamethoxazole in the treatment of bacterial infection?
What is the rationale behind combination of sulfonamides and trimethoprim?

. 1982 Mar-Apr;4(2):593-601.

doi: 10.1093/clinids/4.2.593.

PMID: 6981175
DOI: 10.1093/clinids/4.2.593

Comparative Study

Trimethoprim-sulfamethoxazole and trimethoprim alone for prophylaxis of infection in granulocytopenic patients

M Gurwith et al. Rev Infect Dis. 1982 Mar-Apr.

Abstract

Prophylactic trimethoprim-sulfamethoxazole (TMP-SMZ) has been shown to reduce the incidence of fever, parenteral antibiotic usage, and infections with gram-negative bacteria in hospitalized patients with neutropenia. Furthermore, TMP-SMZ was found to be equivalent to or better than oral, nonabsorbable antibiotics in direct comparisons and to have an additive effect when given together with other oral, nonabsorbable antibiotics. Adults given TMP-SMZ continuously had fewer readmissions for infection than did controls given TMP-SMZ only while hospitalized. TMP-SMZ used continuously in children with acute leukemia was effective in preventing bacterial and Pneumocystis carinii infections. For prophylaxis in granulocytopenic patients, TMP appeared equivalent to TMP-SMZ both in efficacy and incidence of side effects. However, TMP was less effective in suppressing gastrointestinal flora, including TMP-resistant gram-negative rods. Thus, TMP-SMZ has some role in preventing infections in high-risk patients, but further studies, especially comparisons with untreated patients may still be required. TMP used alone offers little advantage and has the theoretical disadvantage of not preventing infections caused by P. carinii or TMP-resistant gram-negative bacteria.

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Publication types

MeSH terms

Substances

Why sulfamethoxazole and trimethoprim is given in combination?

The Combination of Sulfamethoxazole, Trimethoprim, and Isoniazid or Rifampin Is Bactericidal and Prevents the Emergence of Drug Resistance in Mycobacterium tuberculosis.

What is the advantage of using a sulfa drug in combination with trimethoprim?

First, this medication has the special advantage of being able to penetrate into exudates and infected tissues that usually stop other antibiotics at their surface. Similarly, trimethoprim-sulfa can penetrate "sequestered" sites of the body where there is a natural barrier separating certain tissues from the rest.

What is the rationale behind combination of trimethoprim and sulfamethoxazole in the treatment of bacterial infection?

Purpose: The combination of trimethoprim/sulfamethoxazole is often used to treat uncomplicated urinary tract infections in children. The rationale for combining trimethoprim and sulfamethoxazole is that they may act synergistically to increase antibacterial activity.

What is the rationale behind combination of sulfonamides and trimethoprim?

Justification for the combination was based on: (a) synergy occurs in vitro (b) bactericidal activity, while the two components are bacteriostatic (c) the emergence of resistance was claimed to be lower.