From the Guidelines
Bactrim DS is a recommended antibiotic for skin infections, particularly those caused by Staphylococcus aureus, including MRSA, with a typical adult dose of one double-strength tablet (800mg sulfamethoxazole/160mg trimethoprim) taken by mouth twice daily for 7-14 days. When considering the treatment of skin infections, it is essential to weigh the benefits and risks of antibiotic therapy, prioritizing morbidity, mortality, and quality of life as the primary outcomes. According to the guidelines provided by the Infectious Diseases Society of America 1, Bactrim DS (trimethoprim-sulfamethoxazole) is an effective option for treating skin infections, including abscesses, cellulitis, folliculitis, and impetigo.
Key Considerations
- The typical adult dose for skin infections is one double-strength tablet (800mg sulfamethoxazole/160mg trimethoprim) taken by mouth twice daily for 7-14 days, depending on the severity of the infection.
- Bactrim works particularly well against Staphylococcus aureus (including MRSA), making it a good choice for skin infections.
- Common side effects include nausea, vomiting, rash, and sun sensitivity, so use sunscreen while taking it.
- Drink plenty of fluids to prevent kidney stones.
- Bactrim should be avoided by those allergic to sulfa drugs, pregnant women near term, nursing mothers, and patients with severe liver or kidney disease.
Mechanism of Action
Bactrim is effective because it blocks two consecutive steps in bacterial folate synthesis, preventing bacteria from producing DNA and proteins necessary for survival. This mechanism of action makes it a valuable option for treating skin infections caused by susceptible organisms.
Guidelines and Recommendations
The guidelines provided by the Infectious Diseases Society of America 1 recommend the use of Bactrim DS for skin infections, including those caused by MRSA. The guidelines also emphasize the importance of considering the severity of the infection, the presence of comorbidities, and the potential for antibiotic resistance when selecting an antibiotic regimen.
Patient Education
Patients taking Bactrim DS should be educated on the importance of completing the entire prescribed course, even if symptoms improve before finishing. They should also be advised to take the medication with a full glass of water, use sunscreen to prevent sun sensitivity, and drink plenty of fluids to prevent kidney stones.
From the Research
Bactrim DS for Skin Infection
- Bactrim DS, also known as trimethoprim-sulfamethoxazole (TMP-SMX), is an antibiotic used to treat various bacterial infections, including skin infections 2, 3, 4, 5, 6.
- For skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA), TMP-SMX is often used as a treatment option, although its effectiveness can vary 2, 4, 5, 6.
- Studies have compared the efficacy of TMP-SMX with other antibiotics, such as clindamycin and doxycycline, for the treatment of uncomplicated skin infections, including those caused by MRSA 3, 5, 6.
- One study found that minocycline is a preferred treatment option for community-acquired MRSA skin and soft-tissue infections, as it is more effective than TMP-SMX and doxycycline in eradicating the infection 2.
- Another study found that the proportion of patients cured was similar in the TMP-SMX and clindamycin groups for the treatment of uncomplicated skin infections, including both cellulitis and abscesses 3.
- A study on the dose of TMP-SMX for skin and skin structure infections caused by MRSA found that patients treated with a higher dose of TMP-SMX had a similar rate of clinical resolution as patients treated with the standard dose 4.
- Incision and drainage, in addition to antibiotic therapy, is critical for the management of CA-MRSA skin infections, and patients who receive TMP-SMX or clindamycin for their CA-MRSA skin infections experience similar rates of treatment failure 5, 6.
Treatment Options
- TMP-SMX is an effective treatment option for skin infections caused by MRSA, although its effectiveness can vary depending on the severity of the infection and the presence of other underlying conditions 2, 3, 4, 5, 6.
- Clindamycin and doxycycline are also effective treatment options for skin infections caused by MRSA, and the choice of antibiotic should be based on the severity of the infection, the presence of other underlying conditions, and the susceptibility of the infecting organism to the antibiotic 3, 5, 6.
- Incision and drainage, in addition to antibiotic therapy, is critical for the management of CA-MRSA skin infections, and patients who receive TMP-SMX or clindamycin for their CA-MRSA skin infections experience similar rates of treatment failure 5, 6.