Urology-Textbook.com

Up-to-date urology insights from Dirk Manski

 You are here: Urology Textbook > Drugs in Urology > Cotrimoxazole

Cotrimoxazole: Side Effects, Contraindications and Dosage

Cotrimoxazole is an antibiotic with a fixed combination of trimethoprim (Diaminopyrimidine antibiotic group) and sulfamethoxazole (sulfonamide antibiotic group).

Mechanism of Action of Cotrimoxazole

Cotrimoxazole is bactericidal due to the double inhibition of bacterial folic acid synthesis.

Antibiotic Spectrum of Cotrimoxazole:

Broad spectrum activity against aerobic bacteria in the Gram-negative and Gram-positive range. In urology, the typical pathogens of urinary tract infections such as Enterobacteriaceae or Chlamydia are covered, but with increasing resistance rates. Cotrimoxazole is ineffective against anaerobes, enterococci, Treponema pallidum, Pseudomonas, and mycoplasmas.

Urologic Indications for Cotrimoxazole:

Treatment of urinary tract infection (UTI) with proven sensitivity. Antibiotic prophylaxis of UTI.

Pharmacokinetics of Cotrimoxazole

Side Effects of Cotrimoxazole

Cotrimoxazole is relatively well tolerated.

Drug Interactions with Cotrimoxazole

Cotrimoxazole enhances the effect of oral vitamin K antagonists, phenytoin, barbiturates, and sulfonylureas. It increases the toxicity of cyclosporine and methotrexate.

Contraindications of Cotrimoxazole

Dosage of Cotrimoxazole

Monotherapy with Trimethoprim:

Monotherapy with Trimethoprim is an option for uncomplicated or complicated urinary tract infections with proven sensitivity. The daily dose is 200–400 mg, depending on the severity of the disease, and is administered in two separate doses.

 

Antibiotic Prophylaxis of UTI:

Cotrimoxazole 480 mg (80 mg trimethoprim and 400 mg sulfamethoxazole) or trimethoprim alone 100–150 mg once daily p.o. at bedtime or after sexual intercourse.





Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

References

H. R. Brodt, A. Hörauf, M. Kresken, W. Solbach, and T. Welte, Infektionstherapie: Antibiotika, Virostatika, Antimykotika, Antiparasitäre Wirkstoffe. Thieme, 2023.

Drekonja DM, Trautner B, Amundson C, Kuskowski M, Johnson JR. Effect of 7 vs 14 Days of Antibiotic Therapy on Resolution of Symptoms Among Afebrile Men With Urinary Tract Infection: A Randomized Clinical Trial. JAMA. 2021 Jul 27;326(4):324-331. doi: 10.1001/jama.2021.9899.



  Deutsche Version: Cotrimoxazol

Urology-Textbook.com – Choose the Ad-Free, Professional Resource

This website is designed for physicians and medical professionals. It presents diseases of the genital organs through detailed text and images. Some content may not be suitable for children or sensitive readers. Many illustrations are available exclusively to Steady members. Are you a physician and interested in supporting this project? Join Steady to unlock full access to all images and enjoy an ad-free experience. Try it free for 7 days—no obligation.

-->