Sulphamethoxazole + Trimethoprim

In the lab, Cotrimoxazole kills a wide range of Gram-positive and Gram-negative organisms. These include Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Brucella, Pneumocystis carinii, Nocardia and Bordetella. Its activity is particularly high against Haemophilus influenzae, E. coli and Proteus spp., which makes Cotrimoxazole especially suitable for chronic bronchitis and urinary tract infections. It works by blocking two bacterial enzyme systems one after the other in the making of Folinic acid in the micro-organisms. The two steps act together, and this synergy accounts for the high bactericidal activity. Sulphamethoxazole + Trimethoprim (Cotrimoxazole) is indicated in the following. Respiratory tract infections, including acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and broncho-pneumonia, Pneumocystis carinii pneumonitis, sinusitis and otitis media. Genito-urinary tract infections, including urethritis, acute and chronic cystitis, pyelonephritis, prostatitis and gonorrhoea. Gastro-intestinal tract infections caused by Salmonella typhi and Salmonella paratyphi, including the chronic carrier state. Other infections caused by a wide range of organisms confirmed to be susceptible to Cotrimoxazole, where the therapeutic benefits are considered to outweigh the possible occurrence of adverse events. Such infections include acute and chronic osteomyelitis, acute brucellosis, skin infections including pyoderma, abscesses and wound infections, septicaemia, bacillary dysentery and cholera (as an adjuvant to fluid and electrolyte replacement), nocardiosis and mycetoma.