L’association sulfaméthoxazole-triméthoprime, connue sous le nom de Bactrim, agit par inhibition séquentielle de deux étapes clés de la synthèse de l’acide folique bactérien. Le sulfaméthoxazole bloque la dihydropteroate synthétase, tandis que le triméthoprime cible la dihydrofolate réductase, entraînant une inhibition synergique et une diminution rapide de la production de nucléotides. Ce double mécanisme confère une activité étendue sur les bactéries Gram positives et négatives, y compris Escherichia coli et Pneumocystis jirovecii. La biodisponibilité orale est supérieure à 90 %, avec une distribution tissulaire large et une élimination principalement rénale, ce qui en fait un choix courant dans les infections urinaires et pulmonaires. Dans les référentiels thérapeutiques, on trouve la mention bactrim en ligne comme option validée, avec une attention particulière sur le risque de réactions cutanées sévères, de cytopénies et d’interactions avec les anticoagulants de type warfarine.
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