From the Guidelines
Yes, TMP-SMX (trimethoprim-sulfamethoxazole) is available as an oral medication. It comes in tablet form for adults and as a suspension for children or those who have difficulty swallowing tablets. The standard adult tablet strength is typically 80mg trimethoprim/400mg sulfamethoxazole (single strength) or 160mg trimethoprim/800mg sulfamethoxazole (double strength) 1. TMP-SMX is an antibiotic combination that works by inhibiting two consecutive steps in bacterial folate synthesis, making it effective against many common pathogens. It's commonly prescribed for urinary tract infections, certain respiratory infections, and for prophylaxis against opportunistic infections in immunocompromised patients.
Key Points to Consider
- Common dosing for uncomplicated UTIs is one double-strength tablet twice daily for 3 days, while other infections may require different dosing regimens 1.
- The medication should be taken with plenty of water, and patients should complete the full prescribed course even if symptoms improve before finishing the medication.
- According to the guidelines, oral trimethoprim-sulfamethoxazole (160/800 mg [double-strength tablet] twice-daily for 14 days) is an appropriate choice for therapy if the uropathogen is known to be susceptible 1.
- However, if the susceptibility is not known, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone, is recommended 1.
- High rates of resistance to trimethoprim-sulfamethoxazole with corresponding failure rates for resistant isolates make this agent an inferior choice for empirical therapy, but it is highly efficacious in pyelonephritis if the causative organism is susceptible 1.
From the FDA Drug Label
Sulfamethoxazole and trimethoprim is rapidly absorbed following oral administration. Sulfamethoxazole and trimethoprim tablets USP are a synthetic antibacterial combination product available in double strength (DS) tablets, each containing 800 mg sulfamethoxazole USP and 160 mg trimethoprim USP; in tablets, each containing 400 mg sulfamethoxazole USP and 80 mg trimethoprim USP for oral administration Description Sulfamethoxazole and trimethoprim is a synthetic antibacterial combination product available in DS (double strength) tablets, each containing 800 mg sulfamethoxazole, USP and 160 mg trimethoprim, USP; in tablets, each containing 400 mg sulfamethoxazole, USP and 80 mg trimethoprim, USP for oral administration
Yes, TMP SMX is oral, as indicated by the text that it is rapidly absorbed following oral administration and that the tablets are for oral administration 2, 2, 3.
- The oral administration is explicitly mentioned in the drug labels.
- The drug formulation is available in tablets for oral administration.
From the Research
TMP SMX Administration
- TMP SMX can be administered orally, as evidenced by studies on its use in treating urinary tract infections and other conditions 4, 5, 6, 7
- Oral administration of TMP SMX has been shown to be effective in treating various infections, including urinary tract infections and respiratory tract infections 4, 5
- Patient compliance with oral TMP SMX has been reported to be higher compared to other antibiotic regimens, such as co-trimoxazole 5
Forms of TMP SMX
- TMP SMX is available in both oral and intravenous forms 4
- The intravenous form of TMP SMX is often used to treat more severe infections, such as Pneumocystis jiroveci infection in HIV-infected patients 4
- The oral form of TMP SMX is commonly used to treat less severe infections, such as urinary tract infections and respiratory tract infections 4, 5, 6, 7
Efficacy and Safety
- Oral TMP SMX has been shown to be effective in treating various infections, with a low rate of adverse events 4, 5
- The efficacy and safety of oral TMP SMX have been compared to other antibiotic regimens, such as quinolones, in the treatment of urinary tract infections 8, 6
- Resistance to TMP SMX has been reported, particularly in patients with HIV infection 4, 8, 7