Co-Trimoxazole 120 ml Syrup

Medication Name: Co-Trimoxazole 120 ml Syrup (Paediatric Suspension)

Active Ingredient Concentration:

• Trimethoprim (TMP): 40 mg per 5 ml
• Sulfamethoxazole (SMX): 200 mg per 5 ml (Total strength: 240 mg of combined active ingredients per 5 ml teaspoonful)

Pharmacologic Class: Combination antibacterial agent (Sulfonamide and Diaminopyrimidine)

Indications:

Co-Trimoxazole is primarily used to treat infections caused by susceptible bacteria, and the suspension form is typically prescribed for children (from 6 weeks to 12 years of age). Indications include:

• Urinary Tract Infections (UTIs): Including cystitis.
• Acute Otitis Media (Ear Infection): In children.
• Respiratory Tract Infections: Such as acute exacerbations of chronic bronchitis.
• Pneumocystis jirovecii Pneumonia (PJP): Both for treatment and prophylaxis (prevention).
• Other infections: Such as Shigellosis, Toxoplasmosis, and Nocardiosis.

Dosage and Administration (Paediatric):

• Dosage: Must be calculated by a physician based strictly on the child’s age, weight, and the severity and type of infection.
• Standard Dosing (Acute Infections, Children 6 months to 5 years): Typically 5 ml (one teaspoonful) taken every 12 hours (twice daily).
• Standard Dosing (Acute Infections, Children 6 to 12 years): Typically 10 ml (two teaspoonfuls) taken every 12 hours (twice daily).
• For Severe Infections (e.g., PJP): A much higher, weight-based dose is used, administered in divided doses 3 or 4 times daily, as directed by the doctor.
• Administration:
  • Shake the bottle well before measuring.
  • Use the provided measuring device (spoon or syringe) for accuracy.
  • It should be taken with food or drink to lessen gastrointestinal upset.
  • Ensure the child maintains a high fluid intake (water) throughout the course of treatment.
  • The prescribed course must be completed, even if symptoms improve early.

Contraindications:

• Known hypersensitivity (allergy) to Trimethoprim, Sulfamethoxazole, or any sulfonamide-derived drug (e.g., some diuretics).
• Severe hepatic (liver) impairment or severe renal (kidney) failure.
• Documented megaloblastic anemia due to folate deficiency.
• Infants less than 6 weeks of age (risk of kernicterus).
• Patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency.

Precautions:

• Severe Skin Reactions: Immediately discontinue and seek medical help if the child develops a rash, sore throat, or fever (potential signs of SJS/TEN).
• Blood Monitoring: Regular blood tests are needed for long-term treatment or in patients with suspected folate deficiency.
• Fluid Intake: High fluid intake is essential to prevent crystalluria (crystal formation in the urine).