What are the brand names of trimethoprim-sulfamethoxazole (TMP-SMX) for a patient with uncomplicated cystitis?

Brand Names of Trimethoprim-Sulfamethoxazole

The primary brand name for trimethoprim-sulfamethoxazole is Bactrim, available in both regular strength (400 mg sulfamethoxazole/80 mg trimethoprim) and double strength or DS formulation (800 mg sulfamethoxazole/160 mg trimethoprim). 1

Available Formulations

• Bactrim DS (double strength) contains 800 mg sulfamethoxazole and 160 mg trimethoprim per tablet 1
• Bactrim (regular strength) contains 400 mg sulfamethoxazole and 80 mg trimethoprim per tablet 1
• Sulfatrim is another brand name used for this combination antibiotic 2

Recommended Dosing for Uncomplicated Cystitis

• For women with uncomplicated cystitis, the standard dose is one Bactrim DS tablet (160 mg trimethoprim/800 mg sulfamethoxazole) twice daily for 3 days 3, 2
• This 3-day regimen achieves clinical cure rates of 90-100% when the causative organism is susceptible 2

Critical Prescribing Considerations

• Bactrim should only be prescribed empirically when local E. coli resistance rates are below 20% 2, 4
• When organisms are resistant to trimethoprim-sulfamethoxazole, clinical cure rates plummet to only 41-54%, making treatment failure the expected outcome 2
• Patients who have used trimethoprim-sulfamethoxazole in the preceding 3-6 months or traveled outside the United States recently should avoid this agent due to increased resistance risk 2

Alternative First-Line Options When Bactrim Cannot Be Used

• Nitrofurantoin monohydrate/macrocrystals (Macrobid) 100 mg twice daily for 5 days is the preferred alternative, with clinical cure rates of 88-93% 4, 5
• Fosfomycin trometamol 3 g single dose offers convenient single-dose therapy with approximately 90% clinical cure rates 4