Bactrim DS is a drug made of two antibiotics, sulfamethoxazole and trimethoprim; the DS stands for "double strength". Bactrim DS is an effective drug for treating many types of bacterial infections and is widely prescribed for urinary tract infections, otitis media, lung infections and traveler's diarrhea. It is generally a well-tolerated medication but can have serious, potentially fatal, side effects.
Features
Bactrim is an effective antibacterial drug because of the combined action of its two antibiotics. Sulfamethoxazole belongs to a class of drugs called sulfa drugs and trimethoprim is a unique antibiotic. Both antibiotic components of Bactrim function by inhibiting the metabolism of folic acid, a substance important for making proteins. A large proportion of Bactrim-induced side effects are a result of the sulfa-containing part of the antibiotic as well as the drug's method of action.
Types
The most common side effects of Bactrim therapy is nausea and vomiting, loss of appetite and rash or hives. Bactrim-induced side effects in AIDS patients are more common and more severe for unknown reasons, perhaps related to the high doses required for some illnesses in these patients. Bactrim's ability to interfere with folic acid metabolism, both in bacteria and humans, can lead to severe anemia due to folic acid deficiency; this side effect is seen more frequently in the elderly or patients with underlying kidney failure. Elderly patients are also at increased risk of developing thrombocytopenia, a deficiency in platelets, as well as high potassium in the blood.
Risks
The National Institutes of Health warns that severe allergic and hypersensitivity reactions possibly resulting in death have been reported with the use of all sulfa-containing drugs, and Bactrim is no exception. These lethal side effects include skin-sloughing disorders, severe liver destruction and failure as well as suppression of the bone marrow to make red and white blood cells. While taking Bactrim, symptoms such as rash, fever, joint pain, sore throat, and pale or yellow skin should be reported to a health care provider promptly as these may herald the onset of life-threatening complications of Bactrim therapy.
Treatment
Most side effects are mild or resolve with continued use of Bactrim. More severe Bactrim-associated side effects such as hives or significant vomiting may require discontinuation of the drug. Hospitalization may be required for life-threatening complications of Bactrim therapy such as liver and bone marrow toxicity as well as severe dermatologic manifestations.
Warning
Serious drug interactions increasing the risk of side effects have been reported with cyclosporine, methotrexate, phenytoin, procainamide, warfarin and other sulfa-containing drugs such as certain diuretics. Patients should provide their health care provider with a complete list of all other drugs being taken, both described and over-the-counter, before starting Bactrim.
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