LYCOS RETRIEVER 
Trimethoprim
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Trimethoprim/sulfa is both renally excreted unchanged via glomerular filtration and tubular secretion and metabolized by the liver. The sulfas are primarily acetylated and conjugated with glucuronic acid and trimethoprim is metabolized to oxide and hydroxylated metabolites. Trimethoprim may be more extensively metabolized by the liver in adult ruminants than in other species. The serum elimination half-lives for trimethoprim in various species are: 2.5 hours (dogs), 1.91-3 hours (horses), 1.5 hours (cattle). The serum elimination half-lives for sulfadiazine in various species are: 9.84 hours (dogs), 2.71 hours (horses), 2.5 hours (cattle). While trimethoprim is quite rapidly eliminated from the serum, the drug may persist for a longer period of time in tissues.
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Trimethoprim is in the FDA pregnancy category C. This means that it is not known whether trimethoprim will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Trimethoprim passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. Trimethoprim is not approved for use by children younger than 2 months of age.
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Trimethoprim helps prevent urine infections.As your child has been diagnosed with a problem with the urinary system, he or she is more likely to suffer urine infections than other children. Trimethoprim is a useful drug, which helps prevent urine infections. For people with HIV disease, this drug is usually given in a combination form for prevention of PCP. The combination form is trimethoprim/sulfamethoxazole, or TMP/SMX. The brand names for this drug are Bactrim and Septra. Trimethoprim is used in combination with dapsone to treat PCP.
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Trimethoprim may cause anemia due to a deficiency of folic acid. The anemia usually is mild and resolves when the trimethoprim is stopped. Patients who are folate-deficient, such as malnourished, alcoholic, geriatric, or pregnant patients, may be at greater risk for developing anemia with trimethoprim. Warning signs of anemia include white or bluish fingernails and unusual tiredness and weakness. Prolonged therapy can result in low platelet counts, low white blood cell counts, and other toxic effects on the blood cells.
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Trimethoprim has recently been marketed as a single-entity product for the treatment of initial episodes of uncomplicated symptomatic urinary tract infections; it was previously available only in combination with sulfamethoxazole. Trimethoprim exerts antimicrobial activity by blocking the reduction of dihydrofolate to tetrahydrofolate, the active form of folic acid, by susceptible organisms. It has inhibitory activity for most gram-positive aerobic cocci and some gram-negative aerobic bacilli. Resistance to trimethoprim may be either intrinsic or acquired. Acquired resistance most commonly stems from a chromosomal mutation that results in the production of a dihydrofolate reductase enzyme which is less vulnerable to trimethoprim inhibition. Gastrointestinal intolerance and skin eruptions are the most common untoward reactions resulting from the administration of trimethoprim.
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Trimethoprim resistance is increasingly prevalent in community-acquired urinary infections. The objective of this study was to evaluate the association between exposure to community-prescribed trimethoprim and other risk factors in subjects and subsequent trimethoprim-resistant urinary tract infection. The design was a nested case–control study using a record-linkage database. Study subjects submitted a urine sample to the Ninewells Hospital Laboratory between July 1993 and December 1995. Antibiotic exposure in subjects with trimethoprim-resistant isolates (cases) was compared with antibiotic exposure in subjects with trimethoprim-susceptible isolates (controls). Study subjects were drawn from the catchment area of a large teaching hospital in Tayside, Scotland.
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Trimethoprim