Monitoring trimethoprim therapy to ensure drug absorption, clearance, or compliance
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Trimethoprim is coadministered with sulfamethoxazole for prophylaxis or treatment of bacterial infections. These agents are used to treat a variety of infections including methicillin-resistant Staphylococcus aureus, and for prophylaxis in immunosuppressed patients such as HIV-positive individuals.
Trimethoprim has a wide therapeutic index and dose-dependent toxicity. Trimethoprim accumulates in patients with renal failure.
Therapeutic drug monitoring is not commonly performed unless there are concerns about adequate absorption, clearance, or compliance. Accordingly, routine drug monitoring is not indicated in all patients.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Most patients will display peak steady state serum concentrations >2.0 mcg/mL when drawn at least 1 hour after an oral dose. Target concentrations may be higher, depending on the intent of therapy.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Young T, Oliphant C, Araoyinbo I, Volmink J: Co-trimoxazole prophylaxis in HIV: the evidence. S Afr Med J 2008April;98(4):258-259
2. Avdic E, Cosgrove S: Management and control strategies for community-associated methicillin-resistant Staphylococcus aureus. Expert Opin Pharmacother 2008 June;9(9):1463-1479
3. Kamme C, Melander A, Nilsson N: Serum and saliva concentrations of sulfamethoxazole and trimethoprim in adults in children: relation between saliva concentrations and in vitro activity against nasopharyngeal pathogens. Scand J Infect Dis 1983;15:107-113
4. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 11th edition. McGraw-Hill Publishing, 2006, p 1112