From the Guidelines
Dosage and Frequency of Bactrim for Cellulitis
The recommended dosage of Bactrim (trimethoprim/sulfamethoxazole) for purulent cellulitis is 1-2 DS tab PO BID 1. This translates to 160mg/800mg orally every 12 hours. For pediatric patients, the dosage is trimethoprim 4-6 mg/kg/dose, sulfamethoxazole 20-30 mg/kg/dose PO every 12 h 1.
- Key considerations: + Bactrim is pregnancy category C/D and not recommended for women in the third trimester of pregnancy and for children < 2 months of age 1. + The choice of antibiotic should be guided by local epidemiology and the type of skin and soft-tissue infection (SSTI) 1. + Empirical therapy for beta-hemolytic streptococci is recommended, and empirical coverage for CA-MRSA may be considered in patients with systemic toxicity or who do not respond to beta-lactam therapy 1.
- Important notes: + Clindamycin is an alternative option that provides coverage for both beta-hemolytic streptococci and CA-MRSA 1. + Linezolid is another option, but it is more expensive compared to other alternatives 1. + Vancomycin is recommended for complicated SSTI, bacteremia, and infective endocarditis 1.
From the Research
Dosage and Frequency of Bactrim (Trimethoprim/Sulfamethoxazole) for Cellulitis
- The standard dose of Trimethoprim/Sulfamethoxazole (TMP/SMX) for skin and soft tissue infections, including cellulitis, is 160 mg/800 mg twice daily for 7 to 15 days 2.
- A higher dose of TMP/SMX, 320 mg/1,600 mg twice daily for 7 to 15 days, has been studied, but it did not show a significant difference in clinical resolution of infection compared to the standard dose 2.
- The dosage and frequency of Bactrim for cellulitis may vary depending on the specific clinical characteristics and outcomes of the patient, but the study suggests that the standard dose is effective in treating skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA) 2.
- There is no direct evidence from the provided studies to support a specific dosage and frequency of Bactrim for cellulitis in adults living with HIV, as the second study focuses on the benefits of combined preventive therapy with co-trimoxazole and isoniazid in this population 3.