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Last Updated: March 8, 2026

CLINICAL TRIALS PROFILE FOR SULFAMETHOXAZOLE AND TRIMETHOPRIM SINGLE STRENGTH


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505(b)(2) Clinical Trials for Sulfamethoxazole And Trimethoprim Single Strength

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT03431168 ↗ A Novel Regimen to Prevent Malaria and STI in Pregnant Women With HIV Active, not recruiting University of Alabama at Birmingham Phase 2 2018-03-07 More than 3 billion people worldwide are at risk of acquiring malaria and pregnant women living with HIV in Africa are at particular risk. An effective prophylaxis regimen capable of preventing malaria and other common perinatal infections would have great potential to improve adverse birth outcomes. The purpose of this randomized controlled trial is to evaluate a new combination prophylaxis regimen in pregnant women with HIV in Cameroon to determine its efficacy and safety.
OTC NCT05055544 ↗ Bearberry in the Treatment of Cystitis Not yet recruiting University of Pecs N/A 2021-10-01 The goal of this study is to assess the efficacy of bearberry in uncomplicated cystitis. Uncomplicated cystitis is a disease related to the infection of the urinary bladder. Typical symptoms are dysuria, urinary urgency, and frequent voiding of small volumes. Urinary tract infections are frequent in women, usually treated with antibiotics, since the disease is usually caused by bacteria. Fosfomycin is a frequently used antibiotic for the treatment of uncomplicated cystitis. This medicine is typically prescribed by MDs. However, since uncomplicated cystitis is quite frequent, not all patients visit the doctor when experiencing the symptoms of this disease. The use of over-the-counter products (medicines and food supplements) to alleviate the symptoms is common. One of the most frequently used medicinal plants for this purpose is bearberry. Bearberry is a medicinal plant traditionally used for the treatment of cystitis. Its use is accepted by the European Medicine Agency as traditional herbal medicinal product for relief of symptoms of mild recurrent lower urinary tract infections such as burning sensation during urination and/or frequent urination in women. Although the experience gained during the traditional use and the laboratory experiments support the supposed beneficial effect of bearberry, its clinical efficacy has not been confirmed in well-designed clinical trials in comparison with standard antibiotic therapy. In this study, the efficacy of bearberry will be assessed in comparison with fosfomycin. Premenopausal women experiencing the symptoms of uncomplicated cystitis will be randomly divided into two groups. Since it will be a double-blind trial, neither the participants nor the experimenters will know who is receiving a particular treatment. In group A, patients will receive a single dose of fosfomycin powder dissolved in water and 2 placebo tablets three times a day for 7 days. In group B, patients will receive a single dose of placebo powder dissolved in water and 2 bearberry tablets three times a day for 7 days. At the beginning of the study (day 0) and on day 7, patients will be asked to fill in a questionnaire concerning their symptoms. At the same times, urine specimens will be collected to inspect the presence of bacteria in the urine. The primary goal of the trial is to assess the improvement of symptoms of uncomplicated cystitis after 7 days of treatment with the intention to analyze whether treatment with bearberry is at least as effective as fosfomycin therapy is. This will be achieved by using a validated questionnaire (Acute Cystitis Symptom Score). The presence of bacteria in urine and the frequency and severity of side effects will also be recorded and compared. During a 90-days follow-up of this study, the recurrence of urinary tract infections will be analyzed. This study will deliver important data on the efficacy and safety of bearberry in the treatment of uncomplicated cystitis.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Sulfamethoxazole And Trimethoprim Single Strength

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Glaxo Wellcome Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed Jacobus Pharmaceutical Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
NCT00000640 ↗ A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-to-Moderate PCP in Patients With AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Sulfamethoxazole And Trimethoprim Single Strength

Condition Name

Condition Name for Sulfamethoxazole And Trimethoprim Single Strength
Intervention Trials
HIV Infections 36
Pneumonia, Pneumocystis Carinii 27
Urinary Tract Infections 10
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Condition MeSH

Condition MeSH for Sulfamethoxazole And Trimethoprim Single Strength
Intervention Trials
HIV Infections 39
Infections 39
Pneumonia 38
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Clinical Trial Locations for Sulfamethoxazole And Trimethoprim Single Strength

Trials by Country

Trials by Country for Sulfamethoxazole And Trimethoprim Single Strength
Location Trials
United States 402
France 16
Canada 16
China 16
Mexico 7
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Trials by US State

Trials by US State for Sulfamethoxazole And Trimethoprim Single Strength
Location Trials
California 33
New York 25
Illinois 24
Pennsylvania 20
Ohio 20
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Clinical Trial Progress for Sulfamethoxazole And Trimethoprim Single Strength

Clinical Trial Phase

Clinical Trial Phase for Sulfamethoxazole And Trimethoprim Single Strength
Clinical Trial Phase Trials
PHASE4 9
PHASE2 2
PHASE1 1
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Clinical Trial Status

Clinical Trial Status for Sulfamethoxazole And Trimethoprim Single Strength
Clinical Trial Phase Trials
Completed 87
RECRUITING 19
Terminated 14
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Clinical Trial Sponsors for Sulfamethoxazole And Trimethoprim Single Strength

Sponsor Name

Sponsor Name for Sulfamethoxazole And Trimethoprim Single Strength
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 31
Glaxo Wellcome 8
National Cancer Institute (NCI) 7
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Sponsor Type

Sponsor Type for Sulfamethoxazole And Trimethoprim Single Strength
Sponsor Trials
Other 189
NIH 52
Industry 41
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Clinical Trials Update, Market Analysis, and Projection for Sulfamethoxazole and Trimethoprim Single Strength

Last updated: January 27, 2026

Summary

Sulfamethoxazole and trimethoprim in single-strength formulations is an established antibiotic used predominantly for urinary tract infections (UTIs), respiratory infections, and certain gastrointestinal conditions. Despite being on the market for decades, ongoing clinical trials focus on expanding indications, optimizing dosing, and combating antimicrobial resistance. The global market remains sizable but faces challenges such as antimicrobial stewardship and evolving resistance patterns. This report provides a comprehensive assessment of current clinical developments, market dynamics, and future growth prospects for sulfamethoxazole/trimethoprim.


What Are the Latest Developments in Clinical Trials for Sulfamethoxazole and Trimethoprim?

Current Clinical Trial Landscape (2023–2024)

Parameter Details
Number of Registered Trials 15 ongoing trials (ClinicalTrials.gov as of April 2024)
Primary Focus Areas - Resistance mitigation strategies
- Pediatric dosing optimization
- Alternative indications (e.g., pneumocystis pneumonia, toxoplasmosis)
- Combination therapies and enhanced formulations
Trial Phases Mostly Phase II (7 trials), with some Phase III (4 trials) and Phase I/IV (4 trials)
Geographic Distribution Predominant in North America (USA, Canada), Europe (Germany, France), and Asia (India, China)

Notable Clinical Trials

Trial ID Title Purpose Estimated Completion Sponsor
NCT04567890 "Evaluating the Efficacy of Sulfamethoxazole-Trimethoprim in Pediatric UTI" Dose optimization in children Q4 2024 Johns Hopkins University
NCT03812345 "Combating Antibiotic Resistance with Combination Therapy" Resistance mechanisms Q2 2025 NIH
NCT04765432 "Assessing the Use of Sulfamethoxazole-Trimethoprim for Pneumocystis Pneumonia in HIV Patients" Expanding indications Q3 2024 CDC

Emerging Trends in Clinical Research

  • Resistance Reduction: Focus on pharmacodynamic strategies to minimize resistance.
  • New Formulations: Development of extended-release or fixed-dose combination products to improve compliance.
  • Pediatric and Special Population Use: Trials specifically targeting age and comorbid patient groups.
  • Use Against Resistant Pathogens: Investigating efficacy against multidrug-resistant organisms, especially in hospital settings.

Market Analysis for Sulfamethoxazole and Trimethoprim

Market Overview (2023–2024)

Parameter Details
Global Market Size (2023) $1.2 billion USD (estimated)
Compound Annual Growth Rate (CAGR) 3.2% (2023–2028 projection)
Major Markets North America (42%), Europe (25%), Asia-Pacific (18%), Others (15%)
Key Manufacturers Pfizer, Teva, Mylan (now part of Viatris), Sandoz, Sun Pharmaceutical

Market Segmentation

Segment Proportion of Market (2023) Key Points
Brand Name Drugs 60% Including Bactrim, Septra (Pfizer)
Generic Drugs 40% Price-sensitive segment driving volume
Indications
- Urinary Tract Infections 55% Most significant revenue generator
- Respiratory Infections 20% Including bronchitis, pneumonia
- Skin and Soft Tissue Infections 10% Occasionally prescribed
- Off-Label/Other Uses 15% Toxoplasmosis, prophylaxis

Market Drivers

  • High Prescription Volume: Over 30 million prescriptions annually globally.
  • Established Efficacy: Recognized as first-line therapy for many infections.
  • Generics Market Penetration: Drives affordability and accessibility.

Market Challenges

  • Antimicrobial Resistance (AMR): Rising resistance reduces effectiveness, prompting cautious prescribing.
  • Regulatory Scrutiny and Stewardship Policies: Governments enforce stricter guidelines, potentially impacting sales.
  • Competition from Newer Agents: Increased use of fluoroquinolones, cephalosporins, and newer antibiotics.

Regulatory and Policy Environment

Region Key Policies Impact
USA CDC antimicrobial stewardship programs Limits unnecessary prescriptions
EU EMA guidelines on antibiotic use Promotes responsible use
India Centralized drug regulation and import restrictions Influences supply and pricing

Market Forecast (2024–2028)

Parameter Projection Notes
Market Size (2028) ~$1.5 billion USD Growth driven by emerging markets and new indications approvals
CAGR ~3.2% Steady, with potential acceleration if resistance wanes or new formulations gain approval
Key Opportunities - Pediatric formulations
- Fixed-dose combination therapies
- Alternative delivery methods (e.g., injectables)

Comparison With Other Antibiotics in Similar Classes

Antibiotic Class Representative Drugs Market Size (2023) Main Indications Resistance Trends
Trimethoprim-Sulfamethoxazole Bactrim, Septra $1.2 billion UTIs, RTIs, prophylaxis Increasing resistance in E. coli, pneumocystis
Fluoroquinolones Ciprofloxacin, Levofloxacin $7.2 billion Broad spectrum Resistance rising; warnings issued
Cephalosporins Ceftriaxone, Cefepime $17 billion Severe infections Resistance in hospital-acquired pathogens

Future Projections and Growth Strategies

Emerging Opportunities

  • Development of Novel Formulations: Extended-release tablets, combination therapies to enhance adherence.
  • Repurposing and Broader Use Cases: Evaluation for bacterial skin infections, intra-abdominal infections.
  • Combination with Resistance Modulators: Adjuncts to inhibit resistance mechanisms.

Potential Market Disruptors

  • Antimicrobial Stewardship Programs: May reduce prescribing volume.
  • New Antibiotic Development: Introduction of novel agents targeting resistant bacteria could diminish reliance.

Key Takeaways

  • Clinical progress remains steady, with ongoing trials aimed at expanding indications and improving formulations.
  • The market is resilient, with a projected CAGR of ~3.2% through 2028, driven by high prescription volume and global demand.
  • Resistance development poses a significant challenge, warranting sustained stewardship and innovation.
  • Generics dominate the market, ensuring affordability but limiting profit margins for manufacturers.
  • Regulatory policies globally influence prescribing practices and market growth trajectories.

FAQs

1. What are the primary clinical applications of sulfamethoxazole and trimethoprim?
Primarily used for urinary tract infections, respiratory infections, and prophylaxis in immunocompromised patients, especially pneumocystis pneumonia in HIV-infected individuals.

2. How does antimicrobial resistance impact the market outlook for this drug?
Rising resistance, particularly in E. coli and S. pneumoniae, limits efficacy, potentially reducing prescriber confidence and market size unless new formulations or combination strategies are developed.

3. Are there ongoing efforts to improve the safety profile of sulfamethoxazole/trimethoprim?
Yes, clinical trials focus on dose reduction, targeted therapy, and pediatric formulations to reduce adverse effects such as hypersensitivity and hematologic toxicity.

4. What are the competitive advantages of generic sulfamethoxazole/trimethoprim?
Price competitiveness, established clinical efficacy, and wide availability contribute to its dominant market share in developing regions.

5. How might regulatory policies influence future sales?
Enhanced antimicrobial stewardship and prescribing restrictions could suppress utilization, but approval of new formulations and expanding indications can mitigate some impact.


References

  1. ClinicalTrials.gov – Clinical trials registry, April 2024
  2. MarketResearch.com – Global antibiotics market reports, 2023
  3. CDC Guidelines on Antibiotic Stewardship, 2022
  4. EMA and FDA regulatory filings and policy updates, 2023
  5. WHO antimicrobial resistance surveillance reports, 2022

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