Dosing Intervals for Septra

Standard Dosing Intervals

For treatment of severe Pneumocystis jirovecii pneumonia, the Infectious Diseases Society of America recommends a dose of 75-100 mg/kg/day of sulfamethoxazole and 15-20 mg/kg/day of trimethoprim divided every 6 hours for 14-21 days, which translates to approximately 3-5 mg/kg/dose of trimethoprim every 6-8 hours intravenously 1
The Centers for Disease Control and Prevention recommends that for severe MRSA infections, TMP-SMX can be dosed at 5 mg/kg/dose IV every 8-12 hours 2, 3

For patients with creatinine clearance of 15-30 mL/min, the Clinical Infectious Diseases guidelines recommend reducing the dose by half 1, 4
For patients with creatinine clearance below 15 mL/min, the MMWR Recommendations and Reports suggest using half the dose or considering an alternative agent 1, 4
For patients on hemodialysis, the MMWR Recommendations and Reports recommend administering half the dose after each dialysis session 4

The Infectious Diseases Society of America and the Centers for Disease Control and Prevention advise adjusting for renal function, as TMP-SMX accumulates significantly when creatinine clearance drops below 30 mL/min 1, 4