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Supreme (Bactrim)

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This medication is a combination of two antibiotics: sulfamethoxazole and trimethoprim. It is used to treat a wide variety of bacterial infections (such as middle ear, urine, respiratory, and intestinal infections). It is also used to prevent and treat a certain type of pneumonia (pneumocystis-type). This medication treats only certain types of infections. It will not work for viral infections (such as flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

Other names for this medication:
Bactiver, Bactrim, Bactron, Baktar, Balkatrin, Biotrim, Biseptol, Ciplin, Cotrim, Cozole, Deprim, Ditrim, Gantrisin, Globaxol, Kemoprim, Lagatrim, Primadex, Purbac, Resprim, Sanprima, Sepmax, Septra, Septran, Septrin, Soltrim, Sulfa, Sulfamethoxazole, Sulfametoxazol, Sulfatrim, Sumetrolim, Sutrim, Tagremin, Trifen, Trimoks, Trimol, Vanadyl

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Also known as:  Bactrim.


Supreme is effective in a variety of upper and lower respiratory tract infections, renal and urinary tract infections, gastrointestinal tract infections, skin and wound infections, septicaemias and other infections caused by sensitive organisms.

Each Supreme tablet contains 80 mg trimethoprim and 400 mg sulfamethoxazole.

Each Supreme DS (double strength) tablet contains 160 mg trimethoprim and 800 mg sulfamethoxazole.


Shake this medication well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Take this medication by mouth, as directed by your doctor, with a full glass of water (8 ounces / 240 milliliters). If stomach upset occurs, take with food or milk. Drink plenty of fluids while taking this medication to lower the unlikely risk of kidney stones forming, unless your doctor advises you otherwise. Dosage is based on your medical condition and response to treatment.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping it too early may allow bacteria to continue to grow, which may result in a relapse of the infection.


Often, no treatment is needed for an antibiotic overdose. Usually, you'll need to watch for stomach upset and possibly diarrhea. In those cases, you should give extra fluids.


Store at room temperature between 20 to 25 degrees C (68 to 77 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Supreme is contraindicated in pediatric patients less than 2 months of age.

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To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone.

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Of 225 stool cultures that were obtained, 16 (7.1%) were positive for C. difficile. None of the residents with a positive culture was symptomatic. History of nosocomial infection and the use of antibiotics in general, cephalosporins, trimethoprim/sulfamethoxazole (TMP/SMX), and histamine-2 blockers were significantly associated with positive C. difficile culture (P < or = 0.05) by univariate analyses. Trends towards significance (0.05 < 0.10) were noted for narcotic use, previous hospitalization, LTCF, and non-insulin-dependent diabetes mellitus. Logistic regression analysis revealed significant, independent predictors of positive culture: antibiotic use in general (P = 0.028; relative risk = 3.31), histamine-2 antagonist use (P = 0.038; relative risk = 3.27), cephalosporin use (P = 0.038; relative risk = 4.66), and TMP/SMX use (P = 0.007; relative risk = 8.45).

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It was shown that 9 strains of P. mallei were sensitive to sulfanilamides and their combinations with trimethoprim: sulfamonomethoxine + trimethoprim (2.5:1), sulfamethoxazole + trimethoprim (5:1) and sulfazin + trimethoprim (2.5:1 and 5:1). In regard to multiple lowering of the minimum bactericidal concentration of both drugs the combinations of sulfazin with trimethoprim (5:1 or 2.5:1) and sulfamethoxazole with trimethoprim (5:1) or biseptol proved to be the most active. The activity of the sulfamonomethoxine combination with trimethoprim (sulfate) was lower.

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There is the need to properly characterize the temporal trend of U.S. Staphylococcus aureus infections, including methicillin-resistant S. aureus (MRSA) and community-acquired (CA) MRSA in inpatient and outpatient settings.

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Patients with End-stage Renal Disease being immunocompromised; are prone to a variety of infections, sometimes, rare ones, more than the general population. This fact should alert the physicians to be more vigilant and have a broader scope when considering the etiology of infections in such patients. We report the case of a 65-year-old man who had a very stormy hospital stay secondary to cerebral nocardiosis with multiple brain abscesses, prolonged unconsciousness and neurological deficits. However, the patient was treated successfully, surgically and chemotherapeutically. He was discharged home in a good condition.

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The US Food and Drug Administration has scrutinized clinical trial methodology in cellulitis, partly because the definition and timing of cure are debatable. We analysed the validity of telephone self-report as a proxy for in-person follow up in a cellulitis treatment trial comparing cephalexin alone with cephalexin-plus-trimethoprim/sulfamethoxazole. Our results demonstrate poor agreement between these two methods of outcome determination and have implications for future cellulitis clinical trial design and clinical management.

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A few weeks earlier, the patient had had a similar abscess on his leg; he could not recall any specific injuries other than this. He had a past history of epilepsy that is totally unrelated to this case; he had not had any episodes in more than 10 years. Otherwise, the medical history of the patient was relatively healthy: he is a nonsmoker with no history of diabetes or steroid use.

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The purpose of the present study was to investigate the antibiotics utilization in the University Hospital Center of Rijeka (UHC), with capacity of 1566 beds, during the period of 4 years (1990-1994). The data concerning the antibiotics utilization were collected from a hospital pharmacy record and calculated as the defined daily dose (DDD) per 100 bed days. Total antibiotics use decreased continually from 1990 through 1994. According to our study, metronidazole became the most frequently prescribed antibiotic. Comparing the 1994 to the 1990 antibiotics utilization, we may notice an outstanding decrease in cotimoxazole, ampicillin and cefalexin utilization and an increase in amoxicillin + clavulanic acid, gentamycin and cefuroxime (there are no tetracyclines among the 10 most frequently prescribed antibiotics). The changes noticed in the use of antibiotics are partly caused by changes in therapeutic principles, but we consider drug donations as the most important factor. Drug donations have retained the treatment quality of our patients in very difficult conditions in Croatia during the war period.

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Sixty seven children (11mo to 8yr) with chronic otitis media with effusion had tympanocentesis of 105 ears. 38/105 (36%) of the middle ear aspirate cultures were positive. Forty nine organisms were isolated with 10 ears having two or more different bacteria identified. Isolated were 17 Haemophilus influenzae (16 nontype b and 1 type b), 13 Moraxella catarrhalis, nine Streptococcus pneumoniae and 10 'others'. All S pneumoniae(9/9), most H influenzae(14/17) and no M catarrhalis(0/13) were sensitive to amoxycillin. More than 80% of subjects had either a sterile effusion or an organism sensitive to amoxycillin or cotrimoxazole.

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Patients infected with human immunodeficiency virus (HIV) and neurological abnormality compatible with diagnosis of TE were enrolled in the study. These patients were treated with combination of trimethoprim/sulfamethoxazole and pyrimethamine. Response to therapy was assessed by clinical examination and repeat CT/MRI scan done after three weeks of starting treatment. Those showing response were put on prophylactic therapy.

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The prognosis of patients with chronic liver disease and spontaneous bacterial peritonitis is poor, being of great importance its prevention.

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The frequency of multimorbidity in elderly patients may mislead the physician into practicing polypragmasy (polypharmacy), resulting in unpredictable drug interactions. Such interactions are a quite common cause of hospitalization in geriatric patients. Pharmacokinetics are often altered in the aged, and individualized medication should take into consideration not only the patient's age, liver and kidney function, but also the individual variability of hepatic metabolism and drug absorption from the gastrointestinal tract dictated by genetic polymorphism. Drug treatment in the elderly should always be carefully assessed as to its risks and benefits, and, where indicated, certain medications should be replaced by or omitted.

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The initial response rate to intravenous cyclosporine was high (69%). Side effects were documented in the majority of patients, but none of the patients had to discontinue treatment on account of these. Azathioprine has a useful role in maintaining the remission achieved by i.v. cyclosporine for acute ulcerative colitis patients. More than half the patients will avoid colectomy long-term when using triple immunosuppressive therapy including azathioprine adding support Zomax Antibiotic Dose for its relative safety and another role for its use.

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Patients with renal failure who are taking trimethoprim have an increased risk of developing hyperkalemia, which can cause muscle weakness. In patients with postpolio syndrome, a normal creatinine level could be abnormally high, renal failure is possible because of lack of creatinine production, and the muscle weakness from resultant hyperkalemia could be more severe because of their underlying condition. This abnormally high creatinine level has been termed from this point relative renal failure. The objective of the study was to review a case in which relative renal failure and hyperkalemia caused muscle weakness that manifested as shortness of breath and confusion with electrocardiographic changes. A dehydrated patient with relative renal failure and postpolio syndrome had taken trimethoprim-sulfamethoxazole that caused symptomatic hyperkalemia. The patient presented with muscle weakness, shortness of breath, and confusion, with her postpolio syndrome compounding the situation and likely making the muscle weakness more severe. A patient on trimethoprim with renal failure is at an increased risk of developing hyperkalemia. Patients with postpolio syndrome could have severe muscle weakness from the hyperkalemia and could have renal failure even with a normal creatinine level. This case report will remind treating physicians to evaluate such patients for hyperkalemia if they Milixim 50 Mg present with muscle weakness, especially if the patient has renal failure and is on trimethoprim.

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A series of new trimethoprim [5-(3,4,5-trimethoxy-benzyl)-pyrimidine-2,4- diamine] analogues were prepared by condensation of adamantane-1-carbaldehyde with 3-methoxypropionitrile, followed by reaction of resulting mixture of 2-adamantan-1-ylmethyl- Tablet Levomac 500 3-methoxy-acrylonitrile and 3-adamantan-1-yl-2-methoxymethyl-acrylonitrile with guanidine, acetamidine and thiourea, respectively. The activity of compounds obtained and sulfamethoxazole, alone and in combination, against several bacterial strains, as well as fungi was investigated.

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Our definition of CA-MRSA is based on retrospective data from patient and family verbal histories in the medical record. We did not perform molecular genotyping of MRSA samples to confirm community-associated strains Gimalxina Medicine .

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The objective of this study was to investigate the perceived increase in resistance of Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) isolated from the lower respiratory tract of horses to trimethoprim-sulfamethoxazole (SXT). The recorded SXT-susceptibility results of 50 S. zooepidemicus isolates from the tracheal wash fluid of equine patients examined at Colorado State University Veterinary Teaching Hospital from each of 2 time periods (1987-1990 and 1997-2001) were compared and statistically analyzed using a cross-sectional study design. There was a statistically significant difference between the documented resistance of S. zooepidemicus isolated in the 1987-1990 time period (8%), using quantitative microbroth dilution, and the resistance reported for isolates Amoksiklav Buy Online from the 1997-2001 time period (42%), using Kirby-Bauer agar disk diffusion. Laboratory investigation revealed inadequate quality control of media and subsequent falsely reported resistance of S. zooepidemicus from 1997 to 2001 time period. This study demonstrates how minor deviations from prescribed laboratory-testing guidelines can have a major effect on antimicrobial susceptibility test results. The study also underscores the need for regular surveillance and monitoring of trends in antimicrobial susceptibility to detect and correct such problems. In addition, epidemiologists and others collecting data from laboratories should be cautioned to interact with the laboratory regarding interpretation of results of various testing methods to ensure accurate analysis and conclusions.

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A 21-year-old Sulfatrim Ds Drug -airman stationed in the Philippines presented with cavitary pulmonary melioidosis. When treated with trimethoprim-sulfamethoxazole, there was prompt resolution of his symptoms and the left upper lobe abscess cavity. It is suggested that this antimicrobial combination is an effective alternative regimen for pulmonary melioidosis.

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Immediate antimicrobial therapy with trimethoprim-sulfamethoxazole, nitrofurantoin, Gimalxina 250 Mg or fosfomycin is indicated for acute cystitis in adult women. Increasing resistance rates among uropathogens have complicated treatment of acute cystitis. Individualized assessment of risk factors for resistance and regimen tolerability is needed to choose the optimum empirical regimen.

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This study was designed to determine the role of a new temperate DNA phage BcP15 in relation to drug resistance. The multidrug resistant Shigella flexneri NK1925 was isolated from a patient of Infectious Diseases Hospital, Kolkata, India. This strain contained five plasmids ranging in size from 3 to 212 kb. After curing of five plasmids, this strain became sensitive to antibiotics. A plasmidless multidrug-resistant strain Burkholderia cepacia DR11 was isolated during the survey of Binozyt Syrup microorganisms from coastal waters of deltaic Sunderbans. This strain always released a temperate phage BcP15 into culture supernatant. Turbid plaque formation was observed on the lawn of a plasmidless version (Pl(-)35) of Shigella flexneri NK1925. A few distinct clones (Pl(-)35R) appeared within the region of each plaque after 18 h incubation. S. flexneri NK1925, Pl(-)35, and Pl(-)35R clones showed the same PFGE band pattern of XbaI-digested chromosomal DNA. However, Pl(-)35R clones were resistant to co-trimoxazole, trimethoprim, and eryth- romycin, to which B. cepacia DR11 was also resistant. Southern hybridization results indicated that these three antibiotic resistances in Pl(-)35R clones were due to a BcP15 phage lysogen in the Pl(-)35 version of S. flexneri NK1925.