From the Guidelines
The recommended dose of Bactrim (trimethoprim/sulfamethoxazole) for pediatric patients is 4-6 mg/kg of trimethoprim every 12 hours, with a maximum of 8-12 mg/kg/day divided into two doses. This dosage is based on the trimethoprim component and is suitable for most infections, including urinary tract infections and skin infections 1. For urinary tract infections, the typical duration is 3-14 days depending on infection severity, while for skin infections, 7-10 days is common. For Pneumocystis jirovecii pneumonia treatment, higher doses of 15-20 mg/kg/day of trimethoprim are used.
- The medication should be given with plenty of fluids, and dosing should be adjusted for children with renal impairment.
- Bactrim works by inhibiting two sequential steps in bacterial folate synthesis, with trimethoprim blocking dihydrofolate reductase and sulfamethoxazole inhibiting dihydropteroate synthetase.
- Common side effects include rash, gastrointestinal upset, and photosensitivity.
- The medication should be avoided in infants younger than 2 months due to the risk of kernicterus, and caution is needed in patients with G6PD deficiency or sulfa allergies.
- According to the World Health Organization pocket book of hospital care, for otitis media, acute, the recommended dose is 4 mg kg−1 trimethoprim plus 20 mg kg−1 sulfamethoxazole BD for 5 days 1. It's essential to note that the dosage may vary depending on the specific infection and the patient's condition, and it's always best to consult with a healthcare professional for personalized advice.
From the FDA Drug Label
Children: The recommended dose for children with urinary tract infections or acute otitis media is 40 mg/kg sulfamethoxazole and 8 mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours for 10 days. The following table is a guideline for the attainment of this dosage: Children 2 months of age or older: Weight | Dose-every 12 hours lb | kg | Tablets 22-44 | 10-20 | 1 66-88 | 30-40 | 2 (400 mg/80 mg) or 1 (DS) tablet
The recommended dose of Bactrim (trimethoprim/sulfamethoxazole) for pediatric patients is 40 mg/kg sulfamethoxazole and 8 mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours for 10 days, for children with urinary tract infections or acute otitis media, and the dosage can be determined using the provided table based on the child's weight 2.
- The dose for children is based on their weight, with the following guidelines:
- 22-44 lb (10-20 kg): 1 tablet every 12 hours
- 66-88 lb (30-40 kg): 2 tablets (400 mg/80 mg) or 1 double-strength tablet every 12 hours
- Not recommended for use in pediatric patients less than 2 months of age.
From the Research
Bactrim Dose for Pediatrics
The recommended dose of Bactrim (trimethoprim/sulfamethoxazole) for pediatric patients can vary depending on the specific condition being treated and the patient's age and weight.
- For acute urinary tract infections, a dose of 12 mg/kg/day of trimethoprim-sulfamethoxazole has been used in children between 6 months and 10 years of age 3.
- For intravenous administration, a dose of 150 mg of trimethoprim and 750 mg of sulfamethoxazole per m2 every 8 hours has been recommended for children aged 10 years or younger, with adjustments made for patients with renal impairment 4.
- The following are key points to consider when determining the dose:
- Age: Children aged 10 years or younger may require more frequent dosing than adults.
- Weight: The dose should be calculated based on the patient's weight, with a typical dose range of 12 mg/kg/day for trimethoprim-sulfamethoxazole.
- Renal function: Patients with impaired renal function may require adjusted dosing intervals to avoid toxicity.
- It is essential to consult the specific prescribing information and follow the recommended dosing guidelines for Bactrim in pediatric patients to ensure safe and effective treatment.
- Additional studies have investigated the use of trimethoprim-sulfamethoxazole in pediatric patients, including its efficacy in treating urinary tract infections 5, 6, 7.