What is the recommended dosing of Bactrim (Trimethoprim/Sulfamethoxazole) for wound infections?

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Last updated: April 7, 2025View editorial policy

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From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Bactrim (sulfamethoxazole-trimethoprim) for wound infections is typically dosed at 1-2 double-strength tablets (800mg/160mg) twice daily for adults with normal kidney function, as supported by a randomized trial comparing clindamycin and trimethoprim-sulfamethoxazole for uncomplicated wound infection 1.

Key Considerations

  • For children, the dose is calculated based on weight at 8-12mg/kg/day of the trimethoprim component, divided into two doses.
  • Treatment duration is usually 7-14 days depending on infection severity and clinical response.
  • Bactrim is effective against many bacteria that cause skin and soft tissue infections, including MRSA (methicillin-resistant Staphylococcus aureus).

Important Precautions

  • Patients should take the full course even if symptoms improve, drink plenty of fluids to prevent kidney stones, and be aware of potential side effects including rash, nausea, and sun sensitivity.
  • Those with sulfa allergies, severe liver or kidney disease, or pregnant women near term should avoid Bactrim.
  • If the wound shows increasing redness, warmth, swelling, drainage, fever, or fails to improve after 2-3 days of treatment, medical reevaluation is necessary as the infection may require different antibiotics or additional interventions.

Evidence Base

  • A study from 2016 found that clindamycin and trimethoprim-sulfamethoxazole produced similar cure and adverse event rates among patients with an uncomplicated wound infection 1.
  • Another study from 2019 suggested that using trimethoprim/sulfamethoxazole instead of cloxacillin/cefotaxime for prophylaxis may increase the rate of inguinal surgical site infections after lower extremity revascularization 2.
  • However, the most recent and highest quality study should guide clinical decision-making, and in this case, the 2016 study 1 provides the best evidence for the use of Bactrim in wound infections.

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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