Bactiver: Indications, Pharmacokinetics, Dosage, Considerations, Interactions, Precautions and Side Effects

It is an antibiotic used to treat a variety of bacterial infections.

The active substances in bactiver are sulfamethoxazole and trimethoprim (SMX / TMP), also known as cotrimoxazole , among other names.


Bactiver is indicated for the treatment of infectious-inflammatory diseases caused by microorganisms sensitive to cotrimoxazole:

  • Respiratory tract infections (including acute and chronic bronchitis, empyema, bronchiectasis, lung abscess, pneumonia , tonsillitis, pharyngitis).
  • Urinary tract infections (including gonococcal urethritis), cystitis, pyelonephritis, prostatitis.
  • Gastrointestinal infections (including enteritis, typhoid, paratyphoid, dysentery, cholecystitis, cholangitis).
  • Skin and soft tissue infections (pyoderma, furunculosis, wound infection), septicemia, brucellosis.


After oral administration, sulfamethoxazole and trimethoprim are rapidly absorbed from the gastrointestinal tract. Food decreases its absorption. Widely distributed in tissues and body fluids.

The plasma protein binding of trimethoprim is 50%, sulfamethoxazole – 66%. T1 / 2 of trimethoprim is 8.6-17 hours, sulfamethoxazole – 9-11 hours. Trimethoprim is excreted in the urine in unchanged form (50%) and as metabolites. Sulfamethoxazole is also excreted in the urine, mainly unchanged.


Adult dosage

The recommended dosage of sulfamethoxazole / trimethoprim in adults with normal kidney function is as follows:

  • Pneumocystis carinii pneumonia treatment: Weight-based dosage, taken every 6 hours for 14 to 21 days.
  • Prevention of Pneumocystis carinii pneumonia: sulfamethoxazole / trimethoprim 800/160 mg once daily.
  • Treatment of urinary tract infections (UTIs): sulfamethoxazole / trimethoprim 800/160 mg every 12 hours for 10 to 14 days.
  • For Shigellosis or treatment of traveler’s diarrhea: sulfamethoxazole / trimethoprim 800/160 mg every 12 hours for 5 days.
  • Acute worsening of chronic bronchitis treatment: sulfamethoxazole / trimethoprim 800/160 every 12 hours for 14 days.

The 800/160 mg sulfamethoxazole / trimethoprim dose can be taken as one DS (‘double strength’) tablet, two regular strength tablets, or 4 teaspoons (20 ml) of the oral suspension (liquid).

Lower doses of sulfamethoxazole / trimethoprim may be recommended for people with kidney disease.

Dosage for children

  • The recommended dose of sulfamethoxazole / trimethoprim to treat urinary tract infections, ear infections, or Pneumocystis carinii pneumonia in children is based on weight.
  • For the prevention of Pneumocystis carinii pneumonia, the dose is based on body surface area (which your child’s healthcare provider will calculate using your child’s weight and height). Sulfamethoxazole / trimethoprim should never be used in children younger than two months of age.


Some considerations for people taking sulfamethoxazole / trimethoprim include the following:

  • Sulfamethoxazole / trimethoprim comes as a tablet or oral suspension (liquid). It is taken by mouth, usually twice a day (although it is taken as often as four times a day or as infrequently as once a day for certain uses).
  • It can be taken at any time of the day; however, be sure to take the medicine at the same time each day. For example, if you take it twice a day, it is best to evenly space your doses, taking one dose every 12 hours.
  • Make sure to shake the suspension well just before each dose. It is best to use a measuring device such as a medicine spoon or syringe, which are more accurate than kitchen spoons.
  • You can take this medicine with food or on an empty stomach. If your stomach upsets you, try taking it with food.
  • For the drug to work properly, it must be taken as prescribed. Sulfamethoxazole / trimethoprim will not work if you stop taking it too soon.
  • If you are not sure about anything related to your dose or the dosage of sulfamethoxazole / trimethoprim in general, talk to your doctor, nurse or pharmacist.


Some medicines can affect how this medicine works. Tell your doctor if you also use the following medications:

  • Amantadine
  • Cyclosporine .
  • Digoxin.
  • Indomethacin.
  • Memantina.
  • Methotrexate
  • Phenytoin
  • Pirimetamina.
  • Warfarin .
  • An ACE inhibitor, diabetes medications (glipizide, glyburide, metformin, pioglitazone, repaglinide, rosiglitazone).
  • A diuretic (such as hydrochlorothiazide), or tricyclic antidepressants.

There may be other interactions that do not appear in this list.


  • It is not safe to take this medicine during pregnancy. It could harm the fetus. Tell your doctor right away if you become pregnant.
  • Tell your doctor if you are breastfeeding, or if you have kidney or liver disease, diabetes, malabsorption or malnutrition, folic acid deficiency, porphyria, thyroid problems, or a history of alcoholism.
  • Tell your doctor if you have asthma or severe allergies, especially if you are allergic to any medications. It is important for your doctor to know if you have HIV or AIDS, because this medicine may work differently for you.
  • This medicine may cause a severe allergic reaction.
  • This medicine may lower the number of platelets in your body, which are needed for proper blood clotting, which could make it easier for you to bleed or get infections.
  • This medicine can cause diarrhea. Call your doctor if the diarrhea escalates, does not stop, or contains blood. Do not take any medicine to stop diarrhea until you talk to your doctor. Diarrhea may occur 2 months or more after stopping this medicine.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect some medical test results.
  • The doctor will order lab tests during routine appointments to check the effects of this medicine. Keep all your appointments.
  • Keep all medicines out of the reach of children.
  • Never share your medicines with others.

Side effects

See your doctor immediately if you notice any of these side effects:

  • Allergic reaction such as itching or hives, swelling of the face or hands, swelling or tingling in the mouth or throat, tightness in the chest, trouble breathing.
  • Blisters, peeling, or red skin rash.
  • Dark urine or pale stools, nausea, vomiting, poor appetite, stomach pain, yellowing of the skin or eyes.
  • Chest pain, cough, shortness of breath.
  • Confusion, weakness.
  • Muscle spasms.
  • Severe diarrhea, pain, cramps, or bloating.
  • Rash or purple patches on the skin, or very pale or yellowish skin.
  • Sore throat, fever, muscle pain.
  • Irregular heartbeat, numbness, or tingling in the hands, feet, or lips
  • Unusual bleeding, bruising, or weakness.

Talk to your doctor if you notice the following less serious side effects:

  • Moderate nausea
  • Threw up.
  • Loss of appetite

Talk to your doctor if you notice other side effects that you think are caused by this medicine.


Store at room temperature (free from heat, moisture and light).