PO Box 1488
Warrenville, IL 60555
Phone: 331.248.7888
Email: sidp@affinity-strategies.com
n what has been described on Twitter as the “doing your own taxes of medicine,” Drs. Emily Heil (@emilylheil) and Andrew Fratoni (@AFratty) join Dr. Jillian Hayes (@thejillianhayes) to break down the ins and outs of sulfamethoxazole/trimethoprim dosing! Tune in for a discussion on the use of this agent for methicillin-resistant Staphylococcus aureus, gram-negatives, pneumocystis, and Stenotrophomonas maltophilia.
References:
- Twitter Thread re: Bactrim dosing: https://twitter.com/IDdocAdi/status/1661174505702674432?s=20
- IDSA Resistant Gram Negative Guidance Document: https://www.idsociety.org/globalassets/idsa/practice-guidelines/amr-guidance/1.0/idsa-amr-guidance-v3.0.pdf
- (Lower doses of PJP Treatment): Butler-Laporte G, Smyth E, Amar-Zifkin A, Cheng M, McDonald E, Lee T. Low-dose TMP-SMX in the Treatment of Pneumocystis jirovecii Pneumonia: A Systematic Review and Meta-Analysis. Open Forum Infectious Diseases, Volume 7, Issue 5, May 2020, ofaa112, https://doi-org.proxy-hs.researchport.umd.edu/10.1093/ofid/ofaa112
- (DS Vs SS for PJP PPX): Schneider MM, Nielsen TL, Nelsing S, et al. Efficacy and toxicity of two doses of trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus. Dutch AIDS Treatment Group. J Infect Dis. 1995;171(6):1632-1636. Available at: http://www.ncbi.nlm.nih.gov/pubmed/7769306.
- General Bactrim PK/PD: Trubiano JA, Grayson ML. Trimethoprim and Trimethoprim-Sulfamethoxazole (Cotrimoxazole). Chapter 92, Kucers’ The Use of Antibiotics (7th Edition). Taylor & Francis, 2017.
- (2014 IDSA SSTI Guidelines). PMID 24973422
- Cadena J, Nair S, Henao-Martinez AF, Jorgensen JH, Patterson JE, Sreeramoju PV. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2011 Dec;55(12):5430-2. doi: 10.1128/AAC.00706-11. Epub 2011 Sep 19. PMID: 21930870; PMCID: PMC3232808.
- Halilovic J, Heintz BH, Brown J. Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess. J Infect. 2012 Aug;65(2):128-34. doi: 10.1016/j.jinf.2012.03.013. Epub 2012 Mar 21. PMID: 22445732.
- Paul M, Bishara J, Yahav D, Goldberg E, Neuberger A, Ghanem-Zoubi N, Dickstein Y, Nseir W, Dan M, Leibovici L. Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ. 2015 May 14;350:h2219. doi: 10.1136/bmj.h2219. PMID: 25977146; PMCID: PMC4431679.
- Lasko MJ, Gethers ML, Tabor-Rennie JL, Nicolau DP, Kuti JL. In Vitro Time-Kill Studies of Trimethoprim/Sulfamethoxazole against Stenotrophomonas maltophilia versus Escherichia coli Using Cation-Adjusted Mueller-Hinton Broth and ISO-Sensitest Broth. Antimicrob Agents Chemother. 2022 Mar 15;66(3):e0216721. doi: 10.1128/aac.02167-21. Epub 2022 Jan 10. PMID: 35007135; PMCID: PMC8923228.
- Lasko MJ, Tabor-Rennie JL, Nicolau DP, Kuti JL. Trimethoprim/sulfamethoxazole pharmacodynamics against Stenotrophomonas maltophilia in the in vitro chemostat model. J Antimicrob Chemother. 2022 Oct 28;77(11):3187-3193. doi: 10.1093/jac/dkac304. PMID: 36101486.
Emily Heil PharmD, MS, FIDP, BCIDP, AAHIVP
Dr. Emily Heil is an associate professor in the Department of Practice Sciences and Health Outcomes Research at the University of Maryland School of Pharmacy, and she serves as the Pharmacy Director of the Antimicrobial Stewardship Program at the University of Maryland Medical Center. She completed her undergraduate and PharmD at the University of North Carolina in Chapel Hill, where she also completed her pharmacy practice and ID pharmacy residency training. Dr. Heil is an associate editor for Clinical Infectious Diseases. She currently chairs the SIDP International Task Force and is a past board member of SIDP. Dr. Heil is also currently serving as an author on the IDSA Guidance for the Treatment of Gram Negative Infections.
Andrew Fratoni PharmD
Dr. Andrew Fratoni is an Associate Director of Clinical and Laboratory Studies at the Center for Anti-Infective Research and Development at Hartford Hospital. He completed his undergraduate and PharmD studies at the University of Connecticut and went on to complete a PGY1 pharmacy residency at UConn Health followed by a two year ID Pharmacotherapy fellowship at Hartford Hospital. He serves as a subinvestigator on a multitude of phase 1 through 4 clinical trials and was a member of the CLSI ad hoc working group assessing breakpoints for Stenotrophomonas. His research interests include PKPD modeling, patient satisfaction, gram-negative resistance, and PK in special populations.
