Sulfadiazine

KEY POINTS

• Sulfadiazine is a sulfonamide derivative antibiotic that interferes with bacterial growth by inhibiting bacterial folic acid synthesis through competitive antagonism of Para-aminobenzoic acid (PABA)
• Can be used for Toxoplasma gondii treatment or prophylaxis
  • Combined with pyrimethamine and leucovorin for this indication
• Can be used for rheumatic fever prophylaxis
• Oral only
• Usual dose is 2 to 4 grams/day in 3 to 6 divided doses
• Some of the potential concerning adverse effects are: blood dycrasias, dermatologic reactions (including Steven Johnson Syndrome), hepatic necrosis
• Silver sulfadiazine (Silvadene) is a topical and separate product
• Be careful not to confuse sulfadiazine with sulfasalazine

RESOURCES

• Sulfadiazine Package Insert
• AIDS Info Opportunistic Infection Treatment Guideline
• Clinically Available Medicines Demonstrating Anti-Toxoplasma Activity (AAC, 2015)