Sulfonamides (PDF Version)
Sulfonilamide (parent compound of sulfonamides)
Staphylococcus aureus, Coagulase negative Staphylococci, Streptococcus spp., Haemophilus influenzae, Neisseria meningitides, Neisseria gonorrhoeae, Enterobacteriaceae, E. coli, Nocardia spp., Stenotrophomonas, Burkholderia Mycobacteria (non-tuberculosis spp.)
Mechanism of Action:
Sulfonamides compete for PABA in the bacterial pathway responsible for DNA synthesis
Pharmacodynamics
No data
Cmax: 15-200 mcg/L (range); Half-life: Typically 4-16h; Protein binding: 25% to 95%; Table 1
Skin: Rash, toxic epidermal necrolysis, Stevens-Johnson syndrome
Hematologic: Agranulocytosis
GI: Diarrhea
Renal: Interstitial nephritis
Other: Fever
Variable by sulfonamide, Table 1
Disease state based dosing:
Variable by sulfonamide
Contraindications/Warnings/Precautions:
Warning: Will cause hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Usually occurs in first week of therapy. May potentiate the action of concomitantly administered drugs (see Drug Interactions section)
Sulfonamides may potentiate the effects of drugs such as warfarin, sulfonylurea hypoglycemic agents, phenytoin, and methotrexate
Category B: No evidence of risk in humans but studies inadequate.
Monitoring Requirements:
Therapeutic: Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count
Toxic: Urinalysis, BUN, SCr, Skin manifestations of any type, complete white blood cell count,
Brand names/Manufacturer: Various generic manufacturers