Bactrim Dosing for Wound Infections
For wound infections, the recommended dose of Bactrim (sulfamethoxazole-trimethoprim) for adults is 1-2 double-strength tablets (800mg/160mg) twice daily orally. 1
Adult Dosing
- For uncomplicated skin and soft tissue infections (SSTI), the standard adult dose is 1-2 double-strength tablets (800mg/160mg) twice daily by mouth 1
- Duration of therapy is typically 7 days, depending on clinical response 1
- For more severe infections, intravenous administration may be required at a dose of 8-12 mg/kg/day (based on trimethoprim component) divided into 4 doses 1
Pediatric Dosing
- For children, the recommended dose is 8-12 mg/kg/day (based on trimethoprim component) in either 4 divided doses intravenously or 2 divided doses orally 1
- Not recommended for children under 2 months of age 1
Clinical Considerations
Type of Infection
- Bactrim is particularly effective against methicillin-resistant Staphylococcus aureus (MRSA) skin infections 1
- For purulent cellulitis, Bactrim is considered a first-line agent with an AII recommendation level 1
- For non-purulent cellulitis where streptococci are the likely pathogens, beta-lactams are preferred, and Bactrim may have limited efficacy 1
Efficacy Data
- Bactrim is bactericidal against many common wound pathogens 1
- In settings where MRSA is prevalent, Bactrim treatment resulted in higher cure rates for drained cutaneous abscesses compared to placebo (80.5% vs 73.6%) 2
- Bactrim demonstrates good skin/soft tissue penetration and bactericidal activity against strains of S. aureus and β-hemolytic streptococci 3
Important Caveats and Precautions
- Bactrim is pregnancy category C/D and not recommended for women in the third trimester of pregnancy 1
- Monitor for potential side effects, including gastrointestinal disturbances, which are typically mild 2
- Consider alternative agents in patients with sulfa allergies 1
- For wound infections with suspected mixed aerobic-anaerobic bacteria, Bactrim may need to be combined with agents that have anaerobic coverage 1
- For complicated or severe infections, consider inpatient management with parenteral antibiotics 1
Special Populations
- For diabetic foot infections, both standard (160/800 mg) and high doses (320/1600 mg) of Bactrim show good tissue penetration 3
- In immunocompromised patients, Bactrim can be effective but response rates may vary depending on neutrophil counts 4
Remember that incision and drainage remains the primary treatment for purulent collections, with antibiotics serving as adjunctive therapy 1, 2.