Bactrim sulfamethoxazole trimethoprim vs Cipro ciprofloxacin

Bactrim sulfamethoxazole trimethoprim vs Cipro ciprofloxacin

Bactrim vs. Cipro

Bactrim (sulfamethoxazole and trimethoprim) is a combination of two antibiotics. Sulfamethoxazole is an anti-bacterial sulfonamide, a "sulfa" drug, and trimethoprim is a folic acid inhibitor. Bactrim is used to treat infections caused by susceptible bacteria. Examples include urinary tract infections, chronic bronchitis, middle ear infections, prevention of pneumococcus infections in organ transplant recipients, treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and prevention of toxoplasma encephalitis in AIDS patients.

Cipro (ciprofloxacin) is an antibiotic used to treat bacterial infections. It stops bacteria from multiplying by inhibiting the reproduction and repair of their DNA. Cipro is in the fluoroquinolone class of antibiotics. Other fluoroquinolones include levofloxacin (Levaquin), ofloxacin (Floxin), gatifloxacin (Tequin), norfloxacin (Noroxin), moxifloxacin (Avelox), and trovafloxacin (Trovan). Cipro is prescribed for skin, lung, bone, joint, urinary tract infections, infectious diarrhea, anthrax patients with fever and low white blood cell counts, intra-abdominal infections, typhoid fever, gonorrhea, chronic bacterial prostatitis, and acute uncomplicated cystitis.

Side Effects of Bactrim vs. Cipro?


Common side effects of sulfamethoxazole/trimethoprim are:

Other side effects include:

  • liver damage
  • low white blood cell count
  • low platelet count (thrombocytopenia)
  • anemia


Warning: Serious adverse reactions of Cipro and other antibiotics in the fluoroquinolone class have been associated with tendonitis and tendon rupture, particularly the Achilles tendon. Some medical professionals recommend patients discontinue vigorous exercise while taking fluoroquinolone antibiotics.

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Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

The most common side effects of Cipro are:

Anaphylaxis, or shock, is a rare allergic reaction to this drug. This allergic reaction is a medical emergency. Seek medical attention immediately if experiencing these symptoms.

Symptoms of shock include:

  • Cardiovascular collapse
  • Facial or throat swelling
  • Shortness of breath
  • Hives
  • Itching

What are the serious side effects and adverse events of Cipro?

Possible serious side effects of Cipro include:

  • Peripheral neuropathy
  • Central nervous system effects, such as toxic psychosis, nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, tremors, depression, and hallucinations
  • Cipro should be used with caution in patients with central nervous system diseases such as seizures, as rare seizures have been reported
  • Cipro should be avoided in children and adolescents less than 18 years old, as safe use has not been established
  • Many antibiotics, including Cipro, can cause inflammation of the colon (C. difficile or pseudomembranous colitis)
  • Cardiac arrest
  • Respiratory failure

Dosage of Bactrim vs. Cipro


  • The recommended adult dose for urinary tract infections is one double strength tablet (Bactrim DS, Septra DS) or two single strength tablets every 12 hours for 10 to 14 days
  • Flares of chronic bronchitis are treated with a similar regimen for 14 days
  • Sulfamethoxazole/trimethoprim should be taken with 6 to 8 ounces of liquid to prevent crystals from forming in the urine


  • For most infections, the recommended oral dose for adults is 250-750 mg (immediate release tablets) every 12 hours or 500-1000 mg (extended release tablets) every 24 hours
  • The usual intravenous dose is 200-400 mg every 8-12 hours
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Drug Interactions with Bactrim and Cipro?


Sulfamethoxazole/trimethoprim can enhance the blood-thinning effects of warfarin, increase the metabolism of cyclosporine, and add to the kidney damage caused by cyclosporine. Sulfonamides should not be used with methenamine.

Blood levels of phenytoin may be increased by sulfamethoxazole/trimethoprim treatment. This can lead to dizziness and reduced attention.

Sulfamethoxazole/trimethoprim may increase blood levels of digoxin and possibly lead to serious toxic effects. Anemia due to a reduction in folic acid can occur in persons receiving sulfamethoxazole/trimethoprim in combination with divalproex, valproic acid, methotrexate, pyrimethamine, triamterene, or trimetrexate. Increased blood levels of potassium may occur when sulfamethoxazole/trimethoprim is combined with ACE inhibitors.


  • Ciprofloxacin administered with theophylline can lead to elevated, toxic blood levels of theophylline
  • Ciprofloxacin increases the effect of tizanidine
  • Iron salts and antacids may reduce the absorption of ciprofloxacin
  • Ciprofloxacin may increase the blood thinning effect of warfarin
  • Sevelamer may reduce the absorption of ciprofloxacin
  • Administration of ciprofloxacin with diabetic medications may lead to severe low blood glucose
  • Ciprofloxacin may increase blood concentrations of sildenafil
  • Patients taking Cipro can develop sensitivity of the skin to direct sunlight and should avoid exposure to sunlight or use sunblock
  • Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas

Are Bactrim and Cipro Safe to Use While Pregnant or Breastfeeding?


Use of sulfonamides may cause bilirubin to be displaced from proteins in the infant’s blood. Displacement of bilirubin can lead to jaundice and a dangerous condition called kernicterus in the infant. For this reason, sulfamethoxazole/trimethoprim should not be used near term among women. It should not be used by nursing mothers as it is excreted in breast milk and can cause kernicterus.

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Doctors suggest that Cipro should not be used during pregnancy or breastfeeding because its safety is unknown.


Bactrim (sulfamethoxazole and trimethoprim) and Cipro (ciprofloxacin) are antibiotics used to treat bacterial infections. Bactrim is a combination of sulfamethoxazole, an anti-bacterial sulfonamide, and trimethoprim, a folic acid inhibitor. Cipro is in the fluoroquinolone class of antibiotics.


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