Safe Use of Bactrim DS in Patients with Penicillin Allergy

Clinical Guidelines and Recommendations

The Infectious Diseases Society of America recommends Bactrim DS as an alternative treatment option for penicillin-allergic patients 1, 2
For Listeria monocytogenes infections, trimethoprim-sulfamethoxazole is explicitly recommended as "an alternative in the penicillin-allergic patient" with a strength of evidence of A-III 1
For Bartonella bacilliformis infections, trimethoprim-sulfamethoxazole is recommended as one of the treatment options with a strength of evidence of B-III 1
For Tropheryma whipplei infections, trimethoprim-sulfamethoxazole is recommended as a treatment option following initial therapy with a strength of evidence of B-III 1
Bactrim DS should be used with caution in patients with possible folate deficiency, such as the elderly, chronic alcoholics, or patients on anticonvulsants 1
Bactrim DS should be used with caution in patients with glucose-6-phosphate dehydrogenase deficiency due to the risk of hemolysis 1