What is Trimethoprim-Sulfamethoxazole (TMP-SMX) also known as?

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Trimethoprim-Sulfamethoxazole (TMP-SMX) Alternative Names

Trimethoprim-sulfamethoxazole (TMP-SMX) is commonly known as co-trimoxazole, Bactrim, or Sulfatrim. 1, 2

Official Names and Composition

TMP-SMX is a synthetic antibacterial combination product consisting of two active ingredients:

  • Trimethoprim (TMP): 2,4-diamino-5-(3,4,5-trimethoxybenzyl)pyrimidine
  • Sulfamethoxazole (SMX): N1-(5-methyl-3-isoxazolyl) sulfanilamide 1, 2

The medication is available in several formulations:

  • Double strength (DS) tablets: 800 mg sulfamethoxazole + 160 mg trimethoprim
  • Regular strength tablets: 400 mg sulfamethoxazole + 80 mg trimethoprim
  • Pediatric suspension (Sulfatrim Pediatric): Dosed based on body surface area 3

Common Brand Names

While the question specifically asks for alternative names, it's important to note that TMP-SMX is marketed under several brand names worldwide:

  • Bactrim
  • Septra
  • Sulfatrim (particularly for pediatric formulations) 3
  • Co-trimoxazole (international non-proprietary name)

Clinical Context

TMP-SMX is widely used in clinical practice for:

  1. Pneumocystis jirovecii pneumonia (PJP, formerly PCP) prophylaxis and treatment in immunocompromised patients 4
  2. Treatment of various bacterial infections including:
    • Urinary tract infections
    • Respiratory tract infections
    • Gastrointestinal infections (Shigella, non-typhoidal Salmonella) 3
    • Skin and soft tissue infections, including those caused by MRSA 5

Important Considerations

When prescribing TMP-SMX, be aware that:

  • Hypersensitivity reactions are more common in HIV-positive patients (up to 60%) compared to HIV-negative patients (about 5%) 4

  • The medication is contraindicated in:

    • Patients with known hypersensitivity to trimethoprim or sulfonamides
    • Infants younger than 2 months due to risk of kernicterus
    • Patients with severe renal impairment (creatinine clearance <15 mL/min) 3
  • Dosage adjustments are required for patients with renal impairment (creatinine clearance 15-30 mL/min) 3

In summary, TMP-SMX is a widely used antibiotic combination known by several names including co-trimoxazole, Bactrim, and Sulfatrim, with specific formulations tailored for different patient populations and clinical scenarios.

References

Guideline

Sulfatrim Pediatric Treatment Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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