<html>
<head>
<meta charset="UTF-8"/>
<meta name="tikaGenerated" content="true"/>
<meta name="date" content="2022-07-12T06:10:40Z"/>
<meta name="xmp:CreatorTool" content="Microsoft® Word for Microsoft 365"/>
<meta name="Keywords" content="Neonatal Medication Guideline, trimethoprim, infection, urinary tract infection, antibiotic"/>
<meta name="subject" content="Neonatal Medication Guideline"/>
<meta name="dc:creator" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/>
<meta name="dcterms:created" content="2022-07-12T06:10:40Z"/>
<meta name="Last-Modified" content="2022-07-12T06:10:40Z"/>
<meta name="dcterms:modified" content="2022-07-12T06:10:40Z"/>
<meta name="title" content="Trimethoprim"/>
<meta name="Last-Save-Date" content="2022-07-12T06:10:40Z"/>
<meta name="meta:save-date" content="2022-07-12T06:10:40Z"/>
<meta name="dc:title" content="Trimethoprim"/>
<meta name="modified" content="2022-07-12T06:10:40Z"/>
<meta name="cp:subject" content="Neonatal Medication Guideline"/>
<meta name="Content-Type" content="application/pdf"/>
<meta name="creator" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/>
<meta name="meta:author" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/>
<meta name="dc:subject" content="Neonatal Medication Guideline, trimethoprim, infection, urinary tract infection, antibiotic"/>
<meta name="meta:creation-date" content="2022-07-12T06:10:40Z"/>
<meta name="created" content="Tue Jul 12 15:40:40 ACST 2022"/>
<meta name="xmpTPg:NPages" content="3"/>
<meta name="Creation-Date" content="2022-07-12T06:10:40Z"/>
<meta name="meta:keyword" content="Neonatal Medication Guideline, trimethoprim, infection, urinary tract infection, antibiotic"/>
<meta name="Author" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/>
<meta name="producer" content="Microsoft® Word for Microsoft 365"/>
</head>
<body>
<pre>
South Australian Neonatal Medication Guidelines 

trimETHOPRIM 
 10mg/mL oral mixture 

  Department for Health and Wellbeing, Government of South Australia. All rights reserved. 

 

INFORMAL COPY WHEN PRINTED  Page 1 of 3 

OFFICIAL 

 
 

Note:

This guideline provides advice of a general nature.  This statewide guideline has been prepared to promote and facilitate 
standardisation and consistency of practice, using a multidisciplinary approach.  The guideline is based on a review of 
published evidence and expert opinion.  

Information in this statewide guideline is current at the time of publication.  

SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site and does not 
sponsor, approve or endorse materials on such links. 

Health practitioners in the South Australian public health sector are expected to review specific details of each patient and 
professionally assess the applicability of the relevant guideline to that clinical situation. 

If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must document in the 
patient s medical record, the decision made, by whom, and detailed reasons for the departure from the guideline. 

This statewide guideline does not address all the elements of clinical practice and assumes that the individual clinicians are 
responsible for discussing care with consumers in an environment that is culturally appropriate and which enables respectful 
confidential discussion. This includes: 

  The use of interpreter services where necessary, 
  Advising consumers of their choice and ensuring informed consent is obtained, 
  Providing care within scope of practice, meeting all legislative requirements and maintaining standards of 

professional conduct, and  
  Documenting all care in accordance with mandatory and local requirements 

Synonyms 

TMP 

Dose and Indications  

Treatment of susceptible infections 

Oral 

3mg/kg loading dose, then 2mg/kg every twelve hours  

Length of treatment should be guided by pathology and clinical picture 

Prophylaxis for urinary tract infections 

Oral  

2mg/kg once a day 

Prophylaxis for Micturating Cystourethrogram (MCUG) 

Oral  

2mg/kg once a day* for 3 days, with MCUG taking place on the second day 

*Due to limited evidence for optimal dosing in MCUG, consensus decision to use standard 

prophylaxis dose. 

 

 



South Australian Neonatal Medication Guidelines 

 trimETHOPRIM 
 10mg/mL oral mixture 
 

 

 
INFORMAL COPY WHEN PRINTED  Page 2 of 3 

OFFICIAL 

 

 

Preparation and Administration 

Oral 

The 10mg/mL solution contains: 

Dose 2mg 4mg 6mg 8mg 10mg 12mg 

Volume 0.2mL 0.4mL 0.6mL 0.8mL 1mL 1.2mL 

The 10mg/mL oral mixture is not commercially available however is manufactured at the 

Women s and Children s Hospital and can be purchased by other public hospitals.  

Give with feeds to minimise gastrointestinal irritation 

Adverse Effects 

Common 

Fever, rash, vomiting, hyperkalaemia (below) 

Hyperkalaemia can occur with usual doses but is more likely to be clinically significant as 

dose increases. Average onset is 4 5 days. Risk factors are high dose and renal impairment. 

Rare 

Leucopenia, thrombocytopenia, megaloblastic anaemia, methaemoglobinaemia (especially 

with high doses or prolonged treatment), allergy including anaphylaxis, Stevens-Johnson 

syndrome, toxic epidermal necrolysis 

Monitoring 

? Where treatment is prolonged (e.g. greater than 7 days): 

? Monitor potassium, renal function and blood count 

Practice Points 

? Be cautious of prescribing trimethoprim in the following circumstances: 

? patients with severe haematological disorders (folic acid deficiency and blood 

dyscrasias may worsen). Contraindicated in megaloblastic anaemia due to folate 

deficiency 

? patients with renal impairment - reduced or less frequent dosage is recommended 

? patients with hepatic impairment 

? known hyperkalaemia and/or concomitant use of medications that increase the risk 

of hyperkalaemia  

References 

? Urinary tract infections in under 16s: diagnosis and management, 2007, Clinical Guideline, 

National Institution for Health and Care Excellence, accessed online February 2022 



South Australian Neonatal Medication Guidelines 

 trimETHOPRIM 
 10mg/mL oral mixture 
 

 

 
INFORMAL COPY WHEN PRINTED  Page 3 of 3 

OFFICIAL 

 

 

Document Ownership &amp; History 

Developed by: SA Maternal, Neonatal &amp; Gynaecology Community of Practice 

Contact: Health.NeoMed@sa.gov.au 

Endorsed by:  Domain Custodian, Clinical Governance, Safety and Quality 

Next review due:  29/06/2027 

ISBN number:  978-1-76083-395-4 

CGQS reference:  NMG027 

Policy history: Is this a new policy (V1)? N 

 Does this policy amend or update and existing policy?   Y 

 If so, which version? V 2.0 

 Does this policy replace another policy with a different title?  N 

 If so, which policy (title)? 

 

Approval 
Date 

Version 
Who approved New/Revised 
Version 

Reason for Change 

29/06/2022  V3.0 
Domain Custodian, Clinical 
Governance, Safety and Quality 

Reviewed in line with 5 year scheduled 
review 

11/8/2017  V2.0 
SA Health Safety and Quality Strategic 
Governance Committee 

Complete Review 

11/2012  V1.0 
SA Maternal &amp; Neonatal Clinical 
Network  

Original SA Maternal &amp; Neonatal 
Clinical Network approved version. 

 
 
 



</pre>
</body>
</html>