Co-Trimoxazole

A Fixed-dose combination of sulphamethoxazole and trimethoprim in ratio of 5:1. Both inhibit folic acid synthesis by the pathogen but at different stages which results in some potentiation of action. Apart from the usual wide range of susceptible organisms, of interest is the efficacy of this combination against pneumocystis carinil which is an opportunist pathogen causing pneumonia in AIDS patients.

Indications & Dosage:

Oral - Lower Respiratory, Urinary, GI Tract and Genital Tract infections, Otitis Media, Sinusitis, Skin and Wound infections: (Trimethoprim 80mg + ulphamethoxazole 400mg) usual dose 2 tabs b.i.d. Children 6-12 years: 1 tab b.i.d. 6 weeks-5mths: ( Trimethoprim 10 mg + Sulphamethoxazole 50mg) 1 dose b.i.d. Under 6 weeks: not recommended.

Composition:

Each Tablet Contains

(a) Trimethoprim 80mg, Sulphamethoxazole 400mg

(b)Trimethoprim 160mg, Sulphamethoxazole 800mg

Composition(SUSP 60ml):

Each 5ml SUSP contains

Trimethoprim 40mg, Sulphamethoxazole 200mg

Safety Alert:

CL: Hypersens, Severe renal/hepatic damage, infants below 2 months, serious hematological disorders,lactation.
SP: Pregnancy, blood dyscraias, elderly.
INK POT-HAZ: Stevens-Johnson syndrome, agranulocytosis, thrombocytopenia. Others – Renal failure, nausea, vomiting, diarrhea, skin rashes.
LAB INT: Interferes with estimation of serum creatinine.

Doxycycline

Primarily bacteriostatic action through inhibitions of bacterial protein synthesis. Range of susceptible organisms includes Gram-positive and Gram-negative pathogens, Ricketssiae, Chlamydiae, Mycoplasma, Spirochetes, Clostridium species, as well as entamoebae and plasmodia.

Indications & Dosage:

Oral – Infections with Susceptible Organisms: 200 mg on Day 1 followed by 100 mg once daily.

Composition:

Each Capsule Contains

Doxycycline B.P. 100mg

Safety Alert:

CL: Children under 12 years of age, SLE, Pregnancy, lactation, hypersens to tetracyclines.
SP: Impaired hepatic function, blood dyscrasias.
INT POT-HAZ: In seriously ill patients, the reduction in activity due to concurrent administration of antacids, calcium, may be hazardous. Others – Reduction in bioavailability due to divalent or trivalent cations. Antacids, calcium, magnesium and iron reduce absorption.
ADR POT-LT: Rare. Anaphylaxis, liver damage. Others – Permanent staining of teeth, nausea, rash, superinfection, G.I. upsets, glossitis, dysphagia, photosensitivity, haemolytic anameia, thrombocytopenia, neutropenia and eosinophilia.
Raised blood urea, liver enzymes and bilirubin.

LAB INT: Interferes with urinary urobilinogen estimations.

INT FOOD : Unlike most tetracyclines, doxycycline does not interact with food or milk.

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