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Cotrimoxazole

         COTRIMOXAZOLE

COTRIMOXAZOLE is the fixed dose combination of trimethoprim and sulfamethoxazole. 


Sequential block in bacterial folate metabolism PABA-para aminobenzoic acid, DHFA-Dihydrofolic acid, THFA-Tetrahydrofolic acid.



 brand names include are Septra, Bactrim, Apo-Sulfatrim, or Novo-Trimel. Cotrimoxazole comes in tablet and liquid form.


Adverse effects of cotrimoxazole




a) Nausea, vomiting, stomatitis, headache and rashes -

Are common manifestations. 


b) Neonatal haemolysis and methhaemoglobinemia occurs. 

c) Hypersensitivity-

Hypersensitivity reaction like rashes, headache and stomatitis  occurs. 

d) Blood dyscrasis occurs rarely. 

e) Folate deficiency (megaloblastic anaemia) 

Occurs only in patients with marginal folate levels. 

f) Should not be given during pregnancy. Trimethoprim being an antifolate there is a teratogenic risk. 


g) Renal disease patients may develop uraemia. 

h) In elderly patients it may cause bone marrow toxicity. 

i) Diuretic combined with cotrimoxazole produce thrombocytopenia. 



Uses of cotrimoxazole

1 Bacterial diarrhoea and dysentry. 


2) In high dose first line of drug for pneumocystis carnii pneumonia in Aids patient. 

3) for UTI (Urinary tract infection) 

4)  Useful in Tcsinusitis, Tonsillitis, otitis media, pharyngitis & Chronic bronchitis. 

5)  Alternative drug for Granuloma, for protecting neutropenic patient & chanchroid. 

6)  Occasionally employed for ORODENTAL interceptions Especially in patients allergic to beta-lactam antibiotics. 
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