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The effects of trimethoprim causes a backlog of dihydrofolate (DHF) and this backlog can work against the inhibitory effect the drug has on tetrahydrofolate biosynthesis. This is where the sulfamethoxazole comes in; its role is in depleting the excess DHF by preventing it from being synthesised in the first place.
UTI can be categorized into two primary types: cystitis, which refers to lower urinary tract or bladder infection, and pyelonephritis, which indicates upper urinary tract or kidney infection. [1] Escherichia coli (E. Coli) is the predominant microbial trigger of UTIs, accounting for 75% to 95% of reported cases.
The word pyelonephritis is formed by the Greek roots pyelo-from πύελος (púelos) renal pelvis and nephro- from νεφρός (nephrós) kidney together with the suffix -itis from -ῖτις (-itis) used in medicine to indicate diseases or inflammations.
Fosfomycin can be used as an effective treatment for both UTIs and complicated UTIs including acute pyelonephritis. [87] The standard regimen for complicated UTIs is an oral 3g dose administered once every 48 or 72 hours for a total of 3 doses or a 6 grams every 8 hours for 7 days to 14 days when fosfomycin is given in IV form. [87]
Trimethoprim (TMP) is an antibiotic used mainly in the treatment of bladder infections. [1] Other uses include for middle ear infections and travelers' diarrhea. [1] With sulfamethoxazole or dapsone it may be used for Pneumocystis pneumonia in people with HIV/AIDS.
Its Tmax (or time to reach maximum drug concentration in plasma) occurs 1 to 4 hours after oral administration. The mean serum half-life of sulfamethoxazole is 10 hours. [8] However, the half-life of the drug noticeably increases in people with creatinine clearance rates equal to or less than 30 mL/minute.
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Nitrofurantoin is not recommended for the treatment of pyelonephritis (kidney infection), [24] and intra-abdominal abscess, [29] because of extremely poor tissue penetration and low blood levels. [16] [21] Nitrofurantoin appears likely to minimally penetrate the prostate gland.
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