Trimethoprim

Generic Name: Trimethoprim

Brand Names: Bactrim, Polytrim, Primsol, Septra, Sulfatrim

Drug Type: Small Molecule

Chemical Formula: C_₁₄H_₁₈N_₄O_₃

CAS Number: 738-70-5

Unique Ingredient Identifier: AN164J8Y0X

Background: Trimethoprim is an antifolate antibacterial agent that inhibits bacterial dihydrofolate reductase (DHFR), a critical enzyme that catalyzes the formation of tetrahydrofolic acid (THF) - in doing so, it prevents the synthesis of bacterial DNA and ultimately continued bacterial survival. Trimethoprim is often used in combination with sulfamethoxazole due to their complementary and synergistic mechanisms but may be used as a monotherapy in the treatment and/or prophylaxis of urinary tract infections. It is structurally and chemically related to pyrimethamine, another antifolate antimicrobial used in the treatment of plasmodial infections.

Indication: As a monotherapy, trimethoprim is indicated for the treatment of acute episodes of uncomplicated urinary tract infections caused by susceptible bacteria, including E. coli., K. pneumoniae, Enterobacter spp., P. mirabilis, and coagulase-negative Staphylococcus species. In various formulations in combination with sulfamethoxazole, trimethoprim is indicated for the following infections caused by bacteria with documented susceptibility: urinary tract infections, acute otitis media in pediatric patients (when clinically indicated), acute exacerbations of chronic bronchitis in adults, enteritis caused by susceptible Shigella, prophylaxis and treatment of Pneumocystis jiroveci pneumonia, and travelers' diarrhea caused by enterotoxigenic E. coli.

Trimethoprim is available as an ophthalmic solution in combination with polymyxin B for the treatment of acute bacterial conjunctivitis, blepharitis, and blepharoconjunctivitis caused by susceptible bacteria.

Associated Conditions: Acute Exacerbation of Chronic Bronchitis (AECB) caused by susceptible bacteria, Acute Otitis Media caused by susceptible bacteria, Bacterial Conjunctivitis caused by susceptible bacteria, Blepharoconjunctivitis caused by susceptible bacteria, Brucellosis, Dysentery, Bacillary, Nocardiosis, Pneumocystis Jirovecii Pneumonia, Urinary Tract Infection caused by susceptible bacteria, Bacterial blepharitis caused by susceptible bacteria, Susceptible Cholera, Susceptible Enteritis infectious caused by Shigella flexneri, Susceptible Enteritis infectious caused by Shigella sonnei, Susceptible Travelers' Diarrhea caused by Enterotoxigenic E. Coli (ETEC) Infection, Uncomplicated Urinary Tract Infection caused by susceptible bacteria

Clinical Trials

The Efficacy of Trimethoprim in Wound Healing of Patients With Epidermolysis Bullosa

Phase 2

Completed

Conditions: Epidermolysis Bullosa

Interventions: Drug: Trimethoprim

First Posted Date: 2006-09-26

Last Posted Date: 2018-04-19

Lead Sponsor: The Hospital for Sick Children

Target Recruit Count: 10

Registration Number: NCT00380640

Locations: 🇨🇦
The Hospital for Sick Children, Toronto, Ontario, Canada

Steroid-Free Versus Steroid-Based Immunosuppression in Pediatric Renal (Kidney) Transplantation

Phase 1

Completed

Conditions: Kidney Transplant
Renal Transplantation
Kidney Transplantation
Kidney Diseases
Renal Transplant

Interventions: Drug: Daclizumab
Drug: Mycophenolate mofetil (MMF)
Drug: Prednisone
Drug: Ganciclovir
Drug: Tacrolimus
Drug: Valganciclovir
Drug: Trimethoprim and sulfamethoxazole

First Posted Date: 2005-09-01

Last Posted Date: 2016-11-29

Lead Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)

Target Recruit Count: 130

Registration Number: NCT00141037

Locations: 🇺🇸
UCLA - Department of Pediatrics, Division of Nephrology, Los Angeles, California, United States
🇺🇸
Children's Hospital Boston - Division of Nephrology, Boston, Massachusetts, United States
🇺🇸
Children's Hospital of New Orleans-Department of Pediatric Nephrology, New Orleans, Louisiana, United States

and more 9 locations

Combination Immunosuppressive Therapy to Prevent Kidney Transplant Rejection in Adults

Phase 1

Completed

Conditions: Kidney Transplantation
Kidney Disease

Interventions: Drug: Alemtuzumab
Drug: Sirolimus
Drug: Tacrolimus
Procedure: Kidney transplant
Drug: Methylprednisolone (or equivalent)
Drug: Acetaminophen
Drug: Diphenhydramine
Drug: Trimethoprim (TMP)/Sulfa (Bactrim, Septra)
Drug: Valgancyclovir
Drug: Acyclovir
Drug: Pentamidine
Drug: Clotrimazole
Drug: Nystatin

First Posted Date: 2004-03-02

Last Posted Date: 2018-06-29

Lead Sponsor: University of Wisconsin, Madison

Target Recruit Count: 10

Registration Number: NCT00078559

Locations: 🇺🇸
University of Wisconsin - Department of Medicine, Madison, Wisconsin, United States

Randomized Phase I Study of Trimetrexate Glucuronate (TMTX) With Leucovorin (LCV) Protection Plus Dapsone Versus Trimethoprim / Sulfamethoxazole (TMP/SMX) for Treatment of Moderately Severe Episodes of Pneumocystis Carinii Pneumonia

Phase 1

Completed

Conditions: HIV Infections
Pneumonia, Pneumocystis Carinii

First Posted Date: 2001-08-31

Last Posted Date: 2005-06-24

Lead Sponsor: U.S. Bioscience

Target Recruit Count: 20

Registration Number: NCT00002120

Locations: 🇺🇸
Los Angeles County / Health Research Assoc / Drew Med Ctr, Los Angeles, California, United States

Islet Transplantation for Type 1 Diabetes

Phase 2

Completed

Conditions: Diabetes Mellitus, Insulin-Dependent

Interventions: Procedure: Islet Transplantation
Drug: Sirolimus
Drug: Tacrolimus
Drug: Daclizumab
Drug: Sulfamethoxazole
Drug: Ganciclovir
Drug: Trimethoprim
Drug: Pentamidine

First Posted Date: 2001-08-31

Last Posted Date: 2017-03-15

Lead Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)

Target Recruit Count: 36

Registration Number: NCT00014911

Locations: 🇩🇪
Justus-Leibig University, Giessen, Germany
🇨🇦
University of Alberta, Edmonton, Alberta, Canada
🇨🇭
University of Geneva, Geneva, Switzerland

and more 6 locations