Skip to main content
Log in

Distribution of trimethoprim and sulphamethoxazole in blood during treatment with co-trimoxazole

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

Changes in the distribution of sulphamethoxazole and trimethoprim in whole blood, plasma and erythrocytes at steady-state in patients treated with cotrimoxazole have been studied. Unlike sulphamethoxazole, trimethoprim was weakly bound to erythrocytes and was partially liberated when the erythrocytes were rinsed with isotonic saline. The maximal steady-state concentration of trimethoprim in whole blood was 3 mg/l, but calculated on the basis of the concentration determined in erythrocytes it was 1.8 mg/l. Erythrocytes may be of great significance in trimethoprim distribution as carriers of a readily liberated reservoir of the drug. Acetylated sulphamethoxazole derivatives occurred in a higher percentage in erythrocytes at the maximal steady-state concentration (9.9%) than at the level (7.3%), which may help in interpreting the behaviour of this metabolite in other cells in the organism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Böhni E (1969) Vergleichende bakteriologische Untersuchungen mit der Kombination Trimethoprim/Sulphamethoxazole in vitro und in vivo. Chemotherapy 14 [Suppl]: 1–21

    Google Scholar 

  2. Nowak A, Kadyków M, Klimowicz A (1983) Penetration of trimethoprim and sulphamethoxazole into skin blister fluid. Eur J Clin Pharmacol 25: 825–827

    Google Scholar 

  3. Nowak A, Kadyków M, Klimowicz A (1983) Skin contribution to the distribution of co-trimoxazole constituents. Pol Tyg Lek 38: 393–396 (in Polish)

    Google Scholar 

  4. Nowak A, Kadyków M, Klimowicz A (1983) The role of the skin in sulphamethoxazole distribution. Pol Tyg Lek 38: 521–524 (in Polish)

    Google Scholar 

  5. Nowak A, Kadyków M, Klimowicz A (1983) Skin contribution to trimethoprim distribution. Pol Tyg Lek 38: 1077–1078 (in Polish)

    Google Scholar 

  6. Rieder J (1972) Quantitative determination of the bacteriostatically active fraction of sulphonamides and the sum of their inactive metabolites in the body fluids. Chemotherapy 17: 1–21

    Google Scholar 

  7. Rieder J (1976) The simultaneous quantitative determination of ‘total’, ‘active’, ‘acetylated’ and ‘conjugated’ sulfonamide in biological fluids. Chemotherapy 22: 84–87

    Google Scholar 

  8. Bratton AC, Marshall EK Jr, Babbit D, Hendrickson AR (1939) A new coupling component for sulphonamide determination. J Biol Chem 128: 537–550

    Google Scholar 

  9. Klimowicz A (1981) Spectrophotometric determination of trimethoprim in human plasma and blood. Diagn Lab 17: 35–40 (in Polish)

    Google Scholar 

  10. Ludwig E, Csiba A, Magyar T, Szöcs G, Graber H (1983) Age-associated pharmacokinetic changes of metronidazole. Int J Clin Pharmacol 21: 87–91

    Google Scholar 

  11. Richterich R (1971) Clinical chemistry. PZWL, Warszawa, pp 32–35 (in Polish)

  12. Korn A, Hitzenberger H, Jaschek J, Pichler H (1972) Pharmacokinetic of the combination of trimethoprim with sulphamethoxazole. In: Hejzlar M, Semonsky M, Masak S (eds) Advances in antimicrobial and antineoplastic chemotherapy. Avicenum, Czechoslovak Medicinal Press, Prague

    Google Scholar 

  13. Kremers P, Duvivier J, Heugshem C (1974) Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses. J Clin Pharmacol 14: 112–117

    Google Scholar 

  14. Nolte H, Büttner H (1974) Investigation on plasma levels of sulphamethoxazole in man after single and chronic oral administration alone and in combination with trimethoprim. Chemotherapy 20: 321–330

    Google Scholar 

  15. Nolte H, Büttner H (1973) Pharmacokinetics of trimethoprim and its combination with sulphamethoxazole in man after single and chronic oral administration. Chemotherapy 18: 274–284

    Google Scholar 

  16. Neugodova NP, Gejtman IJ, Kiwman GJ (1979) Basic concepts of binding studies of sulfonamides. Khim Pharm J 6: 13–18 (in Russian)

    Google Scholar 

  17. Berneis K, Boguth W (1976) Distribution of sulfonamides and sulfonamide potentiators between red blood cells, proteins and aqueous phases of the blood of different species. Chemotherapy 22: 390–409

    Google Scholar 

  18. Schwartz DE, Ziegler WH (1969) Assay and pharmacokinetics of trimethoprim in man and animals. Postgrad Med J 45 [Suppl]: 32–37

    Google Scholar 

  19. Craig WA, Kunin CM (1973) Trimethoprim-sulphamethoxazole pharmacodynamic effects of urinary pH and impaired renal function. Ann Intern Med 78: 491–497

    Google Scholar 

  20. Kaplan SA, Weinfeld RE, Cotler S, Abruzzo CW, Alexander K (1970) Pharmacokinetic profile of trimethoprim in dog and man. J Pharm Sci 59: 358–363

    Google Scholar 

  21. Lichtenwalner DM, Suh B, Lorber B, Sugar AM (1979) Rapid assay for determination of trimethoprim and sulphamethoxazole levels in serum by spectrofluorometry. Antimicrob Agents Chemother 16: 579–583

    Google Scholar 

  22. Wilkinson PJ, Reeves DS (1979) Tissue penetration of trimethoprim and sulphonamides. J Antimicrob Chemother 5 [Suppl B]: 159–168

    Google Scholar 

  23. Vree TB, Hekster YA, Damsma JE, van der Kleijn E, O'Reilly WJ (1979) Pharmacokinetics of N1-acetyl-and N4-acetylsulphamethoxazole in man. Clin Pharmacokinet 4: 310–319

    Google Scholar 

  24. Witzgall H, Boyens H (1964) Die Bedeutung der Bindung an Albumin, Körperzellen und Bakterien für Pharmakodynamik und Wirkung von Arzneistoffen. Arch Int Pharmacodyn 148: 511–535

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nowak, A., Klimowicz, A. & Kadyków, M. Distribution of trimethoprim and sulphamethoxazole in blood during treatment with co-trimoxazole. Eur J Clin Pharmacol 29, 231–234 (1985). https://doi.org/10.1007/BF00547428

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00547428

Key words

Navigation