Half-Life (Normalesrd) Hours
10/20-50
Plasma Protein Binding %
50
Volume Of Distribution L/Kg
0.28-0.38
Dose For Normal Renal Function
1.0 g q8h
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q12h [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
q18h[D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
q24h [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 1 g after dialysis
Supplement For Dialysis [Recommendation Level]: Pd
PD: 1 g/d
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 2.5-5 mg/kg q12h for mild/moderate infections, 10 mg/kg q12h for severe infection, [B]
References
Berglund F, Killander J, Pompeius R. Effect of trimethoprim-sulfamethoxazole on the renal excretion of creatinine in man. J Urol. 1975; 114: 802-8. [PMID: 1195454] / Golper TA, Gleason JR, Vincent HH, et al. Drug removal during high efficiency and high flux hemodialysis. Contemp Iss Nephrol. 1993; 27: 175-208. [PMID unavailable] / Golper TA, Marx MA. Drug dosing adjustments during continuous renal replacement therapies. Kidney Int Suppl. 1998; 66: S165-8. [PMID: 9573596] / Halstenson CE, Blevins RB, Salem NG, Matzke GR. Trimethoprim-sulfamethoxazole pharmacokinetics during continuous ambulatory peritoneal dialysis. Clin Nephrol. 1984; 22: 239-43. [PMID: 6335067] / Joos B, Schmidli M, Keusch G. Pharmacokinetics of antimicrobial agents in anuric patients during continuous venovenous haemofiltration. Nephrol Dial Transplant. 1996; 11: 1582-5. [PMID: 8856215] / Keane WF, Everett ED, Golper TA, Gokal R, Halstenson C, Kawaguchi Y, et al. Peritoneal dialysis-related peritonitis treatment recommendations. 1993 update. The Ad Hoc Advisory Committee on Peritonitis Management. International Society for Peritoneal Dialysis. Perit Dial Int. 1993; 13: 14-28. [PMID: 8443273] / Siber GR, Gorham CC, Ericson JF, Smith AL. Pharmacokinetics of intravenous trimethoprim-sulfamethoxazole in children and adults with normal and impaired renal function. Rev Infect Dis. 1982; 4: 566-78. [PMID: 6981173] / St Peter WL, Redic-Kill KA, Halstenson CE. Clinical pharmacokinetics of antibiotics in patients with impaired renal function. Clin Pharmacokinet. 1992; 22: 169-210. [PMID: 1559311]
Toxicity Notes
Recommendation if given as single agent. Protein binding decreased in ESRD. Use normal dosing for urinary tract infection in ESRD.