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Last Updated: March 17, 2025

CLINICAL TRIALS PROFILE FOR SULFAMETHOXAZOLE AND TRIMETHOPRIM


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505(b)(2) Clinical Trials for SULFAMETHOXAZOLE AND TRIMETHOPRIM

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial TypeTrial IDTitleStatusSponsorPhaseStart DateSummary
OTC NCT05055544 ↗ Bearberry in the Treatment of Cystitis Not yet recruiting University of Pecs N/A 2021-10-01 The goal of this study is to assess the efficacy of bearberry in uncomplicated cystitis. Uncomplicated cystitis is a disease related to the infection of the urinary bladder. Typical symptoms are dysuria, urinary urgency, and frequent voiding of small volumes. Urinary tract infections are frequent in women, usually treated with antibiotics, since the disease is usually caused by bacteria. Fosfomycin is a frequently used antibiotic for the treatment of uncomplicated cystitis. This medicine is typically prescribed by MDs. However, since uncomplicated cystitis is quite frequent, not all patients visit the doctor when experiencing the symptoms of this disease. The use of over-the-counter products (medicines and food supplements) to alleviate the symptoms is common. One of the most frequently used medicinal plants for this purpose is bearberry. Bearberry is a medicinal plant traditionally used for the treatment of cystitis. Its use is accepted by the European Medicine Agency as traditional herbal medicinal product for relief of symptoms of mild recurrent lower urinary tract infections such as burning sensation during urination and/or frequent urination in women. Although the experience gained during the traditional use and the laboratory experiments support the supposed beneficial effect of bearberry, its clinical efficacy has not been confirmed in well-designed clinical trials in comparison with standard antibiotic therapy. In this study, the efficacy of bearberry will be assessed in comparison with fosfomycin. Premenopausal women experiencing the symptoms of uncomplicated cystitis will be randomly divided into two groups. Since it will be a double-blind trial, neither the participants nor the experimenters will know who is receiving a particular treatment. In group A, patients will receive a single dose of fosfomycin powder dissolved in water and 2 placebo tablets three times a day for 7 days. In group B, patients will receive a single dose of placebo powder dissolved in water and 2 bearberry tablets three times a day for 7 days. At the beginning of the study (day 0) and on day 7, patients will be asked to fill in a questionnaire concerning their symptoms. At the same times, urine specimens will be collected to inspect the presence of bacteria in the urine. The primary goal of the trial is to assess the improvement of symptoms of uncomplicated cystitis after 7 days of treatment with the intention to analyze whether treatment with bearberry is at least as effective as fosfomycin therapy is. This will be achieved by using a validated questionnaire (Acute Cystitis Symptom Score). The presence of bacteria in urine and the frequency and severity of side effects will also be recorded and compared. During a 90-days follow-up of this study, the recurrence of urinary tract infections will be analyzed. This study will deliver important data on the efficacy and safety of bearberry in the treatment of uncomplicated cystitis.
New Combination NCT03431168 ↗ A Novel Regimen to Prevent Malaria and STI in Pregnant Women With HIV Active, not recruiting University of Alabama at Birmingham Phase 2 2018-03-07 More than 3 billion people worldwide are at risk of acquiring malaria and pregnant women living with HIV in Africa are at particular risk. An effective prophylaxis regimen capable of preventing malaria and other common perinatal infections would have great potential to improve adverse birth outcomes. The purpose of this randomized controlled trial is to evaluate a new combination prophylaxis regimen in pregnant women with HIV in Cameroon to determine its efficacy and safety.
>Trial Type>Trial ID>Title>Status>Phase>Start Date>Summary
Showing 1 to 2 of 2 entries

All Clinical Trials for SULFAMETHOXAZOLE AND TRIMETHOPRIM

Trial IDTitleStatusSponsorPhaseStart DateSummary
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Glaxo Wellcome Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Jacobus Pharmaceutical Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000655 ↗ A Randomized, Double-Blind Study of 566C80 Versus Septra (Sulfamethoxazole/Trimethoprim) for the Treatment of Pneumocystis Carinii Pneumonia in AIDS Patients Completed Glaxo Wellcome Phase 2 1969-12-31 To evaluate the effectiveness of atovaquone (566C80) compared to a standard antipneumocystis agent, (SMX/TMP), for the treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in AIDS patients. To compare the safety of short-term (21 days) treatment with 566C80 and SMX/TMP in AIDS patients with an acute episode of PCP. Standard therapies for acute treatment of PCP involve either SMX/TMP or pentamidine isetionate. Although both treatments are equally effective, side effects prevent completion of therapy in 11-55 percent of patients.
>Trial ID>Title>Status>Phase>Start Date>Summary
Showing 1 to 4 of 4 entries

Clinical Trial Conditions for SULFAMETHOXAZOLE AND TRIMETHOPRIM

Condition Name

362798005101520253035HIV InfectionsPneumonia, Pneumocystis CariniiUrinary Tract InfectionsUrinary Tract Infection[disabled in preview]
Condition Name for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Intervention Trials
HIV Infections 36
Pneumonia, Pneumocystis Carinii 27
Urinary Tract Infections 9
Urinary Tract Infection 8
[disabled in preview] 0
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Condition MeSH

3938363400510152025303540HIV InfectionsInfectionsPneumoniaInfection[disabled in preview]
Condition MeSH for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Intervention Trials
HIV Infections 39
Infections 38
Pneumonia 36
Infection 34
[disabled in preview] 0
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Clinical Trial Locations for SULFAMETHOXAZOLE AND TRIMETHOPRIM

Trials by Country

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Trials by Country for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Location Trials
United States 396
China 16
France 16
Canada 15
Mexico 7
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Trials by US State

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Trials by US State for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Location Trials
California 32
New York 25
Illinois 24
Pennsylvania 20
Ohio 19
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Clinical Trial Progress for SULFAMETHOXAZOLE AND TRIMETHOPRIM

Clinical Trial Phase

27.2%36.9%5.8%30.1%0510152025303540Phase 4Phase 3Phase 2/Phase 3[disabled in preview]
Clinical Trial Phase for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Clinical Trial Phase Trials
Phase 4 28
Phase 3 38
Phase 2/Phase 3 6
[disabled in preview] 31
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Clinical Trial Status

67.4%11.6%10.9%10.1%0102030405060708090CompletedRecruitingTerminated[disabled in preview]
Clinical Trial Status for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Clinical Trial Phase Trials
Completed 87
Recruiting 15
Terminated 14
[disabled in preview] 13
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Clinical Trial Sponsors for SULFAMETHOXAZOLE AND TRIMETHOPRIM

Sponsor Name

trials051015202530National Institute of Allergy and Infectious Diseases (NIAID)Glaxo WellcomeNational Cancer Institute (NCI)[disabled in preview]
Sponsor Name for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 31
Glaxo Wellcome 8
National Cancer Institute (NCI) 7
[disabled in preview] 6
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Sponsor Type

64.5%18.8%14.5%0020406080100120140160180OtherNIHIndustry[disabled in preview]
Sponsor Type for SULFAMETHOXAZOLE AND TRIMETHOPRIM
Sponsor Trials
Other 178
NIH 52
Industry 40
[disabled in preview] 6
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Sulfamethoxazole and Trimethoprim: Clinical Trials, Market Analysis, and Projections

Introduction

Sulfamethoxazole and trimethoprim (TMP-SMX) is a widely used antibiotic combination that has been a cornerstone in the treatment of various bacterial infections for decades. This article delves into the current clinical trials, market analysis, and future projections for this drug.

Mechanism of Action

TMP-SMX works by inhibiting bacterial synthesis of tetrahydrofolic acid, a necessary cofactor in the synthesis of thymidine, purines, and bacterial DNA. Sulfamethoxazole inhibits the synthesis of dihydrofolic acid, while trimethoprim competitively inhibits dihydrofolate reductase, leading to a synergistic bactericidal effect. The optimal ratio of trimethoprim to sulfamethoxazole is 1:5, which is reflected in the standard and double-strength tablet formulations[1].

Clinical Uses

TMP-SMX is authorized for the treatment of various bacterial infections, including urinary tract infections, respiratory tract infections, and gastrointestinal infections. It is also used in the prophylaxis of certain infections in immunocompromised patients and those with specific conditions like granulomatosis with polyangiitis (GPA)[3][4].

Prophylaxis in GPA

A recent study published in Rheumatology highlighted the effectiveness of TMP-SMX in reducing serious infections in patients with GPA treated with rituximab. The study found that TMP-SMX prophylaxis significantly reduced the risk of serious infections, with an adjusted hazard ratio of 0.5. However, it also noted an increased risk of adverse events, such as acute kidney injury, emphasizing the need for careful risk-benefit assessment[4].

Safety Review

Health Canada conducted a safety review following a labelling update by the European Medicines Agency (EMA) and found a possible link between TMP-SMX and the risk of hemophagocytic lymphohistiocytosis (HLH), a rare but aggressive condition. Although the evidence was unclear due to study limitations, Health Canada is updating the product safety information and informing healthcare professionals about this potential risk[3].

Market Analysis

The market for sulfamethoxazole and trimethoprim is experiencing significant growth. Here are some key points from recent market analyses:

Market Size and Projections

The global sulfamethoxazole and trimethoprim market is projected to grow substantially. By 2024, the market is expected to be valued at USD 1.56 billion and is anticipated to rise to USD 2.1 billion by 2032, registering a Compound Annual Growth Rate (CAGR) of 3.76% during the forecast period[5].

Market Segmentation

The market is segmented based on type (80mg trimethoprim and 400mg sulfamethoxazole, 160mg trimethoprim and 800mg sulfamethoxazole), application (adult use, pediatric use), and geographical regions (North America, Europe, Asia-Pacific, South America, and Middle-East and Africa)[2][5].

Key Players

The market is dominated by several key players, including Intas Pharmaceuticals Ltd., Macleods Pharmaceuticals Ltd., Glenmark Pharmaceuticals Ltd., Cipla Ltd., and Cadila Healthcare Ltd. These companies are driving the market through their extensive product portfolios and strategic market positioning[5].

Market Dynamics

The market dynamics are influenced by several factors:

Drivers

  • Increasing incidence of bacterial infections
  • Growing demand for cost-effective antibiotics
  • Expanding healthcare infrastructure in developing regions

Restraints

  • Rising antibiotic resistance
  • High cost of newer broad-spectrum antibiotics
  • Potential adverse effects associated with TMP-SMX[1][2][5].

Adverse Effects and Safety Profile

While generally safe, TMP-SMX can cause several adverse effects, particularly gastrointestinal and cutaneous symptoms, which are often mild and reversible. However, rare but serious adverse effects such as HLH and nephrotoxicity have been reported. Trimethoprim can also interfere with serum creatinine assays, leading to mild elevations in serum creatinine levels without affecting the glomerular filtration rate[1][3].

Conclusion

Sulfamethoxazole and trimethoprim remain a crucial component in the treatment and prophylaxis of various bacterial infections. Despite the emergence of newer antibiotics, the combination's efficacy, cost-effectiveness, and established safety profile continue to support its widespread use.

Key Takeaways

  • Clinical Efficacy: Effective in treating and preventing various bacterial infections, including those in immunocompromised patients.
  • Market Growth: Projected to grow significantly, with a CAGR of 3.76% from 2024 to 2032.
  • Safety Concerns: Potential link to rare but serious adverse effects like HLH; careful risk-benefit assessment is necessary.
  • Market Dynamics: Driven by increasing demand for cost-effective antibiotics but restrained by antibiotic resistance and potential adverse effects.

FAQs

Q: What is the mechanism of action of sulfamethoxazole and trimethoprim?

A: Sulfamethoxazole and trimethoprim inhibit bacterial synthesis of tetrahydrofolic acid by blocking two enzymes in the folic acid pathway, leading to a synergistic bactericidal effect[1].

Q: What are the common clinical uses of TMP-SMX?

A: TMP-SMX is used to treat urinary tract infections, respiratory tract infections, gastrointestinal infections, and as prophylaxis in certain conditions like GPA[3][4].

Q: What are the potential adverse effects of TMP-SMX?

A: Common adverse effects include gastrointestinal and cutaneous symptoms. Rare but serious effects include HLH and nephrotoxicity[1][3].

Q: How is the market for TMP-SMX expected to grow?

A: The market is projected to grow from USD 1.56 billion in 2024 to USD 2.1 billion by 2032, with a CAGR of 3.76%[5].

Q: Who are the key players in the TMP-SMX market?

A: Key players include Intas Pharmaceuticals Ltd., Macleods Pharmaceuticals Ltd., Glenmark Pharmaceuticals Ltd., Cipla Ltd., and Cadila Healthcare Ltd.[5].

Sources

  1. Trimethoprim-Sulfamethoxazole Revisited. JAMA Internal Medicine.
  2. Sulfamethoxazole and Trimethoprim Market Size, Scope And Forecast. Market Research Intellect.
  3. Combination Sulfamethoxazole and Trimethoprim - Assessing the Risk of HLH. Health Canada.
  4. Trimethoprim-Sulfamethoxazole Can Reduce Serious Infections in GPA. Rare Disease Advisor.
  5. Sulfamethoxazole Trimethoprim Market Overall Study Report. OpenPR.

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