Trimethoprim and Sulfamethoxazole

ByBrian J. Werth, PharmD, University of Washington School of Pharmacy
Reviewed/Revised Jun 2022 | Modified Sep 2022
VIEW PROFESSIONAL VERSION

antibiotic and is available as a single drug or in combination with sulfamethoxazole (a sulfonamide antibiotic).

Trimethoprim and the combination of trimethoprim and sulfamethoxazole (TMP/SMX) are effective against many gram-positive bacteria and gram-negative bacteria, including susceptible bacteria that are resistant to other antibiotics, such as methicillin-resistant Staphylococcus aureus (MRSA) and some protozoa (Cyclospora and Cystoisospora) and fungi (Pneumocystis

Table

(See also Overview of Antibiotics.)

Use During Pregnancy and Breastfeeding

neural tube defects), such as spina bifida, are a risk. Trimethoprim/sulfamethoxazole should not be used during pregnancy or in newborns because this drug combination may cause jaundice and increases the risk of brain damage (kernicterus) in the newborn. (See also Drug Use During Pregnancy.)

Use of trimethoprim/sulfamethoxazole during breastfeeding is usually discouraged because sulfamethoxazole passes into breast milk. Use of trimethoprim during breastfeeding is generally considered acceptable. (See also Drug Use During Breastfeeding.)

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