Bactrim (sulfamethoxazole/trimethoprim) is a combination antibiotic that can be used for the treatment of acute bacterial or chronic prostatitis.
When you take Bactrim for prostatitis there are several important warnings and precautions you should be aware of. Black box warnings are used by the FDA to communicate important prescribing information to you and your healthcare provider. The FDA considers this essential information to know before taking a medication. There are currently no black box warnings for Bactrim found on the FDA website or in the package insert. However, patients taking Bactrim need to be aware of the following potential severe reactions:
- Blood reactions: Bactrim rarely causes problems in the production of white blood cells (important to fight off infection), red blood cells (oxygen carrying cells), and platelets (cells that help you stop bleeding). Bactrim can cause these problems in isolation or together. Make sure to notify your doctor of increased tiredness, shortness of breath, or other breathing problems after starting Bactrim.
- Stevens-Johnson syndrome and toxic epidermal necrolysis: These are both severe skin reactions that can lead to sloughing of skin, increased risk of infection, and death.
- Colitis: This is a superinfection of your intestines that leads to watery diarrhea.
- Pregnancy: Bactrim use in pregnancy may cause birth defects and should not be used.
Why Is Bactrim Prescribed for Prostatitis?
Bactrim is a combination antibiotic that includes the active ingredients trimethoprim and sulfamethoxazole. It is used to treat other common infections causing prostatitis such as:
- E. coli
- Other Enterobacteriaceae such as Klebsiella pneumonia, Enterobacter cloacae, and Serratia marcescens
- Pseudomonas aeruginosa
Bactrim is a good choice for the above causes of prostatitis because it gets good penetration to the prostate. However, it is primarily used for outpatient treatment, and your doctor may choose a different drug if you require hospitalization. Additionally, local patterns of bacterial resistance to antibiotics will alter your doctor’s choice.
Bactrim is not a good choice for prostatitis caused by Staphylococcus spp. or Enterococcus spp. infections.
How Should Bactrim Be Used?
Bactrim comes in the following formulations:
- Tablet: The tablet is usually taken twice daily. The double strength formulation is most commonly prescribed and contains 800mg sulfamethoxazole and 160 mg trimethoprim.
- Liquid: The oral suspension contains 200 mg sulfamethoxazole and 40 mg trimethoprim per 5 mL.
If you are taking the suspension, make sure you vigorously shake the bottle to evenly mix the medication. Failing to do so means that you may receive too little of the actual antibiotic.
While there are no guidelines for an exact duration of therapy, many providers favor a longer duration (e.g., 4–6 weeks especially if you required hospitalization). You need to make sure that you complete your entire antibiotic course.
Other Uses for Bactrim
Bactrim is also used to treat the following types infections in addition to prostatitis:
- Traveler’s diarrhea
- Urinary tract
Bactrim may also be used in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations and may be used to prevent some infections. Bactrim is not helpful for treating viruses that lead to colds or the flu.
Do I Need to Follow Special Precautions?
Patients with an allergy or previous reaction to Bactrim, sulfa drugs, or trimethoprim should not take Bactrim. If you have ever had a reaction to another sulfa drug or drug containing trimethoprim, you need to let your doctor know. Examples of other sulfa include:
Make sure that you tell your doctor about any other medications you may be taking. Bactrim may not be a good choice for the treatment of prostatitis if you are taking other drugs that may lead to reactions such as:
- Blood thinners like Coumadin (warfarin), used for the treatment of blood clots, combined with Bactrim can increase your risk of bleeding.
- Dilantin (phenytoin), an anti-seizure medication, combined with Bactrim can dangerously alter the Dilantin levels in your body.
- Sandimmune (cyclosporine), a medicine used in transplant patients, combined with Bactrim can lead to kidney damage.
- Aldactone (spironolactone), a diuretic, combined with Bactrim can lead to dangerously high potassium levels.
Do I Need to Follow a Special Diet When Taking Bactrim?
Bactrim can lead to an upset stomach, so it should be taken with food and a glass of water.
What If I Forget a Dose?
If you forget a dose when taking Bactrim, take the missed dose as soon as possible. If you are close to the next dose do not double the dose and continue on the regular dosing schedule until the entire antibiotic is gone.
Are There Side Effects When Taking Bactrim for Prostatitis?
All drugs have side effects. In general Bactrim is well tolerated by most patients and serious side effects are not common. You should tell your doctor if any of the following side effects last more than a couple of days:
- Loss of appetite
- Upset stomach
Additionally, elderly patients and those with AIDS, G6PD deficiency, and porphyria are at increased risk of experiencing side effects and should probably not take Bactrim.
If you experience any of the following when taking Bactrim for prostatitis, stop Bactrim immediately and talk with your doctor:
- Bruising or bleeding
- Fever or chills
- Jaundice or yellowing of the eyes
- Joint aches or swelling
- Mouth sores
- Skin rash
- Sore throat
Does Bactrim Have Special Storage Instructions?
Keep Bactrim in a safe place outside the reach of small children. Neither the tablets nor suspension should be stored in extremes of heat or cold, and both forms do fine at room temperature. When using the suspension, throw away any remaining antibiotic when you have completed the recommended course.
What Do I Do in the Case of an Accidental Overdose?
If you take too many Bactrim pills call your local poison control center. If someone has taken an overdose and is not breathing or responding, call 911.
What Else Should I Know about Bactrim for Prostatitis?
Make sure that you follow any instructions given to you by your doctor. Do not share your antibiotics, and complete the entire course even if you feel dramatically better.