Septrin for Infusion

/ Perrigo

Trimethoprim- sulfamethoxazole for Infusion is for administration ONLY by
the intravenous route and must be diluted before administration.
The duration of the infusion should be approximately 1 to 1.5 hours, but this
needs to be balanced against the fluid requirements of the patient.
When fluid restriction is necessary, Trimethoprim- sulfamethoxazole for
Infusion may be administered at a higher concentration, 5 ml diluted with 75
ml of glucose 5% w/v in water. The resultant solution, whilst being clear to
the naked eye, may on occasion exceed the BP limits set for particulate matter
in large volume parenterals. The solution should be infused over a period not
exceeding an hour.
ACUTE INFECTIONS
Treatment should be continued until the patient has been symptom free for
two days; the majority will require treatment for at least 5 days.
For severe infections in all age groups dosage may be increased by 50%.
Adults and children over 12 years: Standard dosage: 2 ampoules (10 ml) every 12 hours.
Children aged 12 years and under: The recommended dosage is approximately 6mg trimethoprim and 30mg sulphamethoxazole per kilogram bodyweight per 24 hours, given in two equally divided doses.
As a guide, the following schedules may be used diluted as described:
6 weeks to 5 months: 1.25 ml every 12 hours.
6 months to 5 years: 2.5 ml every 12 hours
6 to 12 years: 5.0 ml every 12 hours.
Renal impairment: Adults and children over 12 years (no information is available for children under 12 years of age):
Creatinine Clearance greater than 30: STANDARD DOSAGE
Creatinine Clearance 15 to 30: Half the STANDARD DOSAGE.
Creatinine Clearance less than 15: Not recommended.
Measurements of plasma concentration of sulphamethoxazole at intervals of 2-3 days are recommended in samples obtained 12 hours after administration of Trimethoprim- sulfamethoxazole for Infusion. If the concentration of total sulphamethoxazole exceeds 150 mcg/ml then treatment should be interrupted until the value falls below 120 mcg/ml.
PNEUMOCYSTIS JIROVECI (CARINII) PNEUMONITIS
Treatment: 15-20mg trimethoprim and 75 – 100 mg sulphamethoxazole per kilogram body weight per day in two or more divided doses. Therapy should be
changed to the oral route as soon as possible and continued for a total treatment period of two weeks. The aim is to obtain peak plasma or serum
levels of trimethoprim of ≥5 mcg/ml.
Prevention: Standard dosage for the duration of the period at risk.

Bacterial infections, respiratory infections, gastro-intestinal tract and skin infections.

Septrin presentations should not be given to patients with a history of hypersensitivity to sulphonamides, trimethoprim, co-trimoxazole or any excipients of the presentations.
Contra-indicated in patients with severe renal insufficiency where repeated
measurements monitoring of plasma drug concentration cannot be performed.
Use in patients with severe impairment of liver function.
Use in patients with existent or severe blood dyscrasias.
Use in patients with glucose-6-phosphate dehydrogenase deficiency.
Septrin should not be given to premature babies nor to full- term infants during the first 6 weeks of life.

Reactions including Stevens-Johnson syndrome, Lyell syndrome, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, other blood dyscrasias and hypersensitivity of the respiratory tract, fluid overload is possible when very high doses are being administered to patients with underlying cardio-pulmonary disease, elderly or suspected folate-deficient patients, folate supplementation should be considered, severe allergy or bronchial asthma, streptococcal pharyngitis. Should not routinely be used during pregnancy unless in the judgement of the clinician the potential benefit to the mother justifies the potential risk to the foetus.

Most are mild and comprise nausea, with or without vomiting and skin rashes, respiratory hypersensitivity.

Diuretics (mainly thiazides) in elderly patients.