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Bactrim (co-trimoxazole)

Bactrim is an antibiotic used by patients on the Marshall Protocol (MP). Bactrim is a combination of two antibiotics, trimethoprim and sulfamethoxazole. This antibiotic combination is thought to work synergistically by inhibiting several steps in the process by which bacteria synthesize folate for their use.

Bactrim is the brand name. It is also known as Septra, Sulfatrim, Cotrim, Novo-Trimel, Nu-Cotrimox, Resprim, Roubac and Septrin. The generic name is co-trimoxazole.

Bactrim has a reputation for targeting the bacteria in the gastrointestinal tract. Either generic or brand name is appropriate to use.

Dosing and administration

Related article: Dividing medications

Bactrim comes in one of two dosing combinations of sulfamethoxazole and trimethoprim. Bactrim, or Bactrim SS (Single Strength) is 400mg:80mg and Bactrim DS (Double Strength) is 800mg:160mg.

The MP starting dose of Bactrim is single strength (or half a DS tablet) and the maximum dose is one DS tablet. Bactrim is taken in doses of SS or DS every 48 hours (every 2 days). When taken with another antibiotic that is dosed every other day, Bactrim is taken at the same time as the other antibiotic.

Allergies to sulfa medications?

Many patients with Th1 inflammation have been told that they are allergic to sulfa preparations. This “allergic” reaction experienced in the past was most likely an immunopathological reaction.

These patients should begin with 1/4 tablet (or less) of single strength Bactrim and ramp up by 1/4 increments every two weeks (or as symptoms allow) to a full tablet. Then, they should progress to Bactrim DS. Cutaneous reactions such as pruritus and rash are common and may be treated palliatively.

A complete blood count (CBC) with differential will help identify those very few patients who may develop a rapid drop in red blood cells (RBC), which would require lowering of the Bactrim dosage.

Combining Bactrim with other Marshall Protocol antibiotics

Bactrim may be taken on its own with Olmesartan, or in any combination with other MP antibiotics. It works by modifying a pathogen's ability to metabolize Folic Acid, a different pathway from that used by any of the other MP antibiotics.

Typical targets for immunopathology

Bactrim is sometimes prescribed for the non-MP application of traveler's diarrhea. Patients on the MP have reported stronger gastrointestinal immunopathology (IP) when taking Bactrim. Other commonly reported IP include increased fatigue and skin symptoms.


Notes and comments

  • Legacy content

From Trevor (include this in methotrexate and folic acid articles?):

Folic Acid is already on our list of foods to minimize, as it is an essential part of the nutrition for some families of bacteria (your body needs some folate, but it is added to most bread and flour these days)

In fact the drug Methotrexate, one of the most prescribed drugs for chronic inflammatory conditions, is an antibiotic which knocks-out the Folate metabolism by blocking the bacterial DHFR receptor. However, it also blocks the human DHFR, which is not a good thing at all

The drug Trimethoprim, one of our Phase 3 antibiotics (Bactrim is a mixture of Sulfamethoxazole and Trimethoprim), also blocks the bacterial DHFR receptor, but does not block the human DHFR receptor. Altogether a better solution A picture of DHFR from E.coli with Trimethoprim bound into it is shown below:


Last modified: 05.27.2013
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