From the Research
Bactrim (trimethoprim-sulfamethoxazole) is typically prescribed for 7-14 days to treat lacrimal stones (dacryoliths) with associated infection, as evidenced by the most recent study on antimicrobial susceptibility in adult dacryocystitis 1. The standard adult dosage is usually one double-strength tablet (160mg trimethoprim/800mg sulfamethoxazole) twice daily. For children, the dosage is based on weight. Treatment may be extended if symptoms persist or if there is evidence of ongoing infection. Bactrim works by inhibiting bacterial synthesis of folic acid, which is effective against many common pathogens that cause lacrimal system infections, including methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa, as shown in the study 1. However, antibiotic treatment alone may not be sufficient for complete resolution of lacrimal stones. Additional interventions such as warm compresses, lacrimal irrigation, or surgical removal may be necessary depending on the size and location of the stones. If symptoms worsen or do not improve after 3-5 days of treatment, reevaluation is recommended, considering the results of the study on endoscopic mechanical and powered dacryocystorhinostomy in acute dacryocystitis and lacrimal abscess 2. Patients should complete the full course of antibiotics even if symptoms improve to prevent recurrence and antibiotic resistance. It is also important to note that the microbiology and antimicrobial susceptibility of dacryocystitis can vary, and the use of broad-spectrum antibiotics like Bactrim should be guided by the most recent and highest quality evidence, such as the study published in 2024 1.
Some key points to consider when treating lacrimal stones with Bactrim include:
- The effectiveness of Bactrim against common pathogens that cause lacrimal system infections, as shown in the study 1
- The importance of completing the full course of antibiotics to prevent recurrence and antibiotic resistance
- The potential need for additional interventions, such as warm compresses, lacrimal irrigation, or surgical removal, depending on the size and location of the stones
- The variation in microbiology and antimicrobial susceptibility of dacryocystitis, and the need to guide treatment with the most recent and highest quality evidence, such as the study published in 2024 1