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Evaluation of Weight-Based Co-trimoxazole Dosing in a Saudi Tertiary Hospital

Samah Alshehri1, Rawan Alghuraybi1, Elaf Ayoub1

  • 1Clinical Pharmacy, King Abdulaziz University, Jeddah, SAU.

Cureus
|November 29, 2023
PubMed
Abstract

Insights

Co-trimoxazole dosing for Stenotrophomonas maltophilia and Pneumocystis jirovecii pneumonia (PJP) in adults was often inappropriate. A significant number of patients received underdosed co-trimoxazole, particularly those treated for S. maltophilia infections.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Stenotrophomonas maltophilia and Pneumocystis jirovecii pneumonia (PJP) infections necessitate precise weight-based dosing of co-trimoxazole.
  • Assessing the accuracy of co-trimoxazole dosing is crucial for effective treatment of these specific infections in hospitalized patients.

Purpose of the Study:

  • To evaluate the appropriateness of weight-based co-trimoxazole dosing in adult inpatients.
  • To identify the frequency of appropriate dosing and underdosing for S. maltophilia and PJP infections.

Main Methods:

  • A single-center, cross-sectional study was conducted.
  • Included adult inpatients receiving weight-based co-trimoxazole for S. maltophilia or PJP.
  • The primary endpoint was the assessment of co-trimoxazole dosing appropriateness.

Main Results:

  • Out of 43 patients, 29 were treated for PJP and 14 for S. maltophilia.
  • Overall, co-trimoxazole dosing was appropriate in 51.2% of patients.
  • Underdosing occurred in 48.8% of patients, with a higher rate (92.9%) in the S. maltophilia group compared to the PJP group (27.6%).

Conclusions:

  • Hospitalized adults treated with co-trimoxazole for PJP and S. maltophilia infections exhibit a high incidence of underdosing.
  • Weight-based dosing of co-trimoxazole requires careful attention to ensure therapeutic efficacy, especially for S. maltophilia infections.
Keywords:
co-trimoxazoledosepjppneumocystis jiroveci pneumoniapneumocystis jiroveciistenotrophomonas maltophiliatrimethoprimweight-based dosing

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