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Septra

Clinical Pharmacology
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Clinical Pharmacology

Septra

The usual spectrum of antimicrobial activity of SEPTRA includes bacterial pathogens isolated from middle ear exudate and from bronchial secretions {Haemophilus influenzae, including ampicillin- resistant strains, and Streptococcus pneumoniae), and enterotoxigenic strains of Escherichia coli (ETEC) causing bacterial gastroenteritis. Shigella flexneri and Shigella sonnei are also usually susceptible.

REPRESENTATIVE MINIMUM INHIBITORY CONCENTRATION VALUES FOR ORGANISMS SUSCEPTIBLE TO SEPTRA (MICµg/mL)

Bacteria TMP Alone SMX Alone TMP/SMX(1:19)
TMP SMX
Escherichia coli 0.05-1.5 1.0-245 0.05-0.5 0.95-9.5
Escherichia coli (enterotoxigenic strains) 0.015-0.15 0.285- > 950 0.005-0.15 0.095-2.85
Proteus species (indole positive) 0.5-5.0 . 7.35-300 0.05-1.5 0.95-28.5
Bacteria TMP Alone SMX Alone TMP/SMX(1:19)
TMP SMX
Morganella morganii 0.5-5.0 7.35-300 0.05-1.5 0.95-28.5
Proteus mirabilis 0.5-1.5 7.35-30 0.05-0.15 0.95-2.85
Klebsiella species 0.15-5.0 2.45-245 0.05-1.5 0.95-28.5
Enterobacter species 0.15-5.0 2.45-245 0.05-1.5 0.95-28.5
Haemophilus influenzae 0.15-1.5 2.85-95 0.015-0.15 0.285-2.85
Bacteria TMP Alone SMX Alone TMP/SMX(1:19)
TMP SMX
Streptococcus pneumoniae 0.15-1.5 7.35-24.5 0.05-0.15 0.95-2.85
Shigella flexneri* < 0.01-0.04 < 0.16- > 320 O.002-0.03 0.04-0.625
Shigella sonnei* 0.02-0.08 0.625- > 320 0.004-0.06 0.08-1.25
TMP=trimethoprim
SMX=sulfamethoxazole
*Rudoy RC, Nelson JD, Haltalin KC. Antimicrobial Agents and Chemotherapy. 1974;5:439-443.

Susceptibility Testing

The recommended quantitative disc susceptibility method may be used for estimating the susceptibility of bacteria to SEPTRA.4,5 With this procedure, a report from the laboratory of "Susceptible to trimethoprim and sulfamethoxazole" indicates that the infection is likely to respond to therapy with SEPTRA. If the infection is confined to the urine, a report of "Intermediate susceptibility to trimethoprim and sulfamethoxazole" also indicates that the infection is likely to respond. A report of "Resistant to trimethoprim and sulfamethoxazole" indicates that the infection is unlikely to respond to therapy with SEPTRA.

REFERENCES

1. Kremers P, Duvivier J, Heusghem C. Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses. J Clin Pharmacol. 1974;14:112-117.

2. Kaplan SA, Weinfeld RE, Abruzzo CW, McFaden K, Jack ML, Weissman L. Pharmacokinetic profile of trimethoprim- sulfamethoxazole in man. J Infect Dis. 1973;128(suppl):S547-S555.

3. Varoqaux O, et al. Pharmacokinetics of the trimethoprimsulfamethoxazole combination in the elderly. Br J Clin Pharmacol. 1985; 20: 575-581.

4. Antibiotic susceptibility discs; certification procedure. Federal Register. 1972;37:20527-20529.

5. Bauer AW, Kirby WMM, Sherris JC, Turck M. Antibiotic susceptibility testing by standardized single disk method. Am J Clin Pathol. 1966;45:493-496.

6. Brumfitt W, Pursell R. Trimethoprim-sulfamethoxazole in the treatment of bacteriuria in women. J Infect Dis. 1973;128 (suppl):S657-S663.

7. Marinella MA. Trimethoprim - induced hyperkalemia: An analysis of reported cases. Gerontology 45: 209-212, 1999.

Brand Name: Septra
Generic Name: Trimethoprim and Sulfamethoxazole

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