Here’s the full structured profile for the Co-trimoxazole Oral Suspension (Pediatric formulation) 👇
💊 Co-trimoxazole Oral Liquid 200 mg (Sulphamethoxazole) + 40 mg (Trimethoprim) / 5 mL
📘 Description:
A pediatric fixed-dose antibacterial suspension containing:
- Sulphamethoxazole (A) – 200 mg per 5 mL
(sulfonamide; inhibits dihydropteroate synthase) - Trimethoprim (B) – 40 mg per 5 mL
(dihydrofolate reductase inhibitor)
The combination inhibits sequential steps of folic acid synthesis, leading to a synergistic bactericidal effect.
📄 Prescription / Indications:
Used in children (and adults unable to swallow tablets) for:
- Urinary tract infections (UTIs)
- Respiratory tract infections – bronchitis, otitis media, sinusitis, pneumonia
- Gastrointestinal infections – shigellosis, traveler’s diarrhea
- Skin and soft tissue infections
- Pneumocystis jirovecii pneumonia (PCP) – treatment & prophylaxis in children with HIV/AIDS
- Toxoplasmosis & Nocardiosis (special situations, in combination)
🌿 Nature / Drug Class:
- Antibacterial combination
- Sulfonamide + Diaminopyrimidine
- Bactericidal (synergistic effect)
✅ Advantages:
- Broad-spectrum coverage against Gram-positive & Gram-negative bacteria
- Synergistic action → reduces resistance development
- Liquid form allows accurate weight-based dosing in pediatrics
- Widely available and cost-effective
⚠️ Precautions:
Contraindications:
- Infants <2 months (risk of kernicterus)
- Sulfonamide or trimethoprim allergy
- Severe hepatic or renal impairment
- Late pregnancy & breastfeeding
Use with caution:
- In patients with folate deficiency
- Renal impairment → dose adjustment needed
- HIV-positive children → higher risk of rash, neutropenia
Monitoring (if prolonged use):
- CBC (risk of bone marrow suppression)
- Renal & liver function tests
Adverse effects:
- GI upset (nausea, vomiting, diarrhea)
- Rash, pruritus, urticaria
- Rare but serious: Stevens–Johnson syndrome, TEN, aplastic anemia, agranulocytosis
- Hyperkalemia in prolonged/high-dose therapy
👉 Advise caregivers: Ensure adequate hydration to prevent crystalluria.
📦 Common Packaging:
- 100 mL or 60 mL bottles with dosing spoon/dropper
- Pediatric formulation often labeled as Paediatric Suspension
❄️ Storage Conditions:
- Store at room temperature (<25°C)
- Protect from light & moisture
- Once opened, use within the recommended period (usually 7–14 days)
- Keep out of reach of children