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Last Updated: December 16, 2025

CLINICAL TRIALS PROFILE FOR SULFAMETHOXAZOLE


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505(b)(2) Clinical Trials for sulfamethoxazole

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

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.
NCT00000655 ↗ A Randomized, Double-Blind Study of 566C80 Versus Septra (Sulfamethoxazole/Trimethoprim) for the Treatment of Pneumocystis Carinii Pneumonia in AIDS Patients Completed Glaxo Wellcome Phase 2 1969-12-31 To evaluate the effectiveness of atovaquone (566C80) compared to a standard antipneumocystis agent, (SMX/TMP), for the treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in AIDS patients. To compare the safety of short-term (21 days) treatment with 566C80 and SMX/TMP in AIDS patients with an acute episode of PCP. Standard therapies for acute treatment of PCP involve either SMX/TMP or pentamidine isetionate. Although both treatments are equally effective, side effects prevent completion of therapy in 11-55 percent of patients.
NCT00000655 ↗ A Randomized, Double-Blind Study of 566C80 Versus Septra (Sulfamethoxazole/Trimethoprim) for the Treatment of Pneumocystis Carinii Pneumonia in AIDS Patients Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To evaluate the effectiveness of atovaquone (566C80) compared to a standard antipneumocystis agent, (SMX/TMP), for the treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in AIDS patients. To compare the safety of short-term (21 days) treatment with 566C80 and SMX/TMP in AIDS patients with an acute episode of PCP. Standard therapies for acute treatment of PCP involve either SMX/TMP or pentamidine isetionate. Although both treatments are equally effective, side effects prevent completion of therapy in 11-55 percent of patients.
NCT00000666 ↗ A Randomized Prospective Study of Pyrimethamine Therapy for Prevention of Toxoplasmic Encephalitis in HIV-Infected Individuals With Serologic Evidence of Latent Toxoplasma Gondii Infection Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To evaluate pyrimethamine as a prophylactic agent against toxoplasmic encephalitis in individuals who are coinfected with HIV and latent Toxoplasma gondii. Toxoplasmic encephalitis is a major cause of illness and death in AIDS patients. Standard treatment for toxoplasmic encephalitis is to combine pyrimethamine and sulfadiazine. Continuous treatment is necessary to prevent recurrence of the disease, but constant use of pyrimethamine/sulfadiazine is associated with toxicity. Clindamycin has been shown to be effective in treatment of toxoplasmic encephalitis in animal studies. This study evaluates pyrimethamine as a preventive treatment against toxoplasmic encephalitis (per 3/26/91 amendment, clindamycin arm was discontinued).
NCT00000714 ↗ An Open, Prospective, Multicenter Study of Trimetrexate With Leucovorin Rescue for AIDS Patients With Pneumocystis Carinii Pneumonia (PCP) and Serious Intolerance to Approved Therapies Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To determine the safety and effectiveness of an investigational drug therapy (trimetrexate plus leucovorin calcium (TMTX / LCV)) in the treatment of Pneumocystis carinii pneumonia (PCP) in patients who have AIDS, are HIV positive, or are at high risk for HIV infection, and who have suffered severe or life-threatening ill effects from both conventional therapies for PCP. AMENDED: 08/01/90 As of August 31, 1989, 437 patients were enrolled into uncontrolled studies of trimetrexate for PCP:214 in TX 301/ACTG 0=039 (trimetrexate for patients intolerant of approved therapies) and 223 in NS 401 (trimetrexate for patients refractory to approved therapies). The analysis of overall response rate, stringently defined as having received at least 14 days of trimetrexate and being alive at follow-up 1 month after the completion of therapy, reveals 84/159 intolerant patients and 48/160 refractory patients had responded, for rates of 53 percent and 30 percent, respectively. These response rates include all individuals who received at least one dose of trimetrexate. Of the 111 patients who were ventilator-dependent at study entry, 18 completed a course of therapy and were alive a month later, for a response rate of 16 percent. All other ventilated patients died. The most common severe (grades 3 and 4) toxicities were: transaminase elevation (> 5 x normal) in 94 patients, anemia (< 7.9 g/dl) in 109, neutropenia (< 750 cells/mm3) in 58, fever (> 40 C) in 37, and thrombocytopenia (< 50000 platelets/mm3) in 27. Toxicity required discontinuation of therapy in approximately 5 percent of all patients. Original design: The drugs usually used to treat PCP in AIDS patients, trimethoprim / sulfamethoxazole and pentamidine, have had to be discontinued in many patients because of severe side effects. Currently there are no proven alternatives to these drugs. TMTX was chosen for this trial because it was found to be very active against the PCP organism in laboratory tests. Also TMTX, in combination with LCV, had a high response rate and did not cause severe toxicity in a preliminary trial.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for sulfamethoxazole

Condition Name

Condition Name for sulfamethoxazole
Intervention Trials
HIV Infections 36
Pneumonia, Pneumocystis Carinii 27
Urinary Tract Infections 10
Urinary Tract Infection 8
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Condition MeSH

Condition MeSH for sulfamethoxazole
Intervention Trials
HIV Infections 39
Infections 38
Pneumonia 36
Infection 34
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Clinical Trial Locations for sulfamethoxazole

Trials by Country

Trials by Country for sulfamethoxazole
Location Trials
United States 413
China 18
France 16
Canada 16
Mexico 7
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Trials by US State

Trials by US State for sulfamethoxazole
Location Trials
California 33
New York 25
Illinois 24
Texas 22
Pennsylvania 20
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Clinical Trial Progress for sulfamethoxazole

Clinical Trial Phase

Clinical Trial Phase for sulfamethoxazole
Clinical Trial Phase Trials
PHASE4 6
PHASE2 3
Phase 4 29
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Clinical Trial Status

Clinical Trial Status for sulfamethoxazole
Clinical Trial Phase Trials
Completed 93
Recruiting 19
Terminated 16
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Clinical Trial Sponsors for sulfamethoxazole

Sponsor Name

Sponsor Name for sulfamethoxazole
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 32
M.D. Anderson Cancer Center 10
Glaxo Wellcome 8
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Sponsor Type

Sponsor Type for sulfamethoxazole
Sponsor Trials
Other 208
NIH 53
Industry 43
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Clinical Trials Update, Market Analysis, and Projection for Sulfamethoxazole

Last updated: October 31, 2025

Introduction

Sulfamethoxazole, a sulfonamide antibiotic, remains a critical component in combating bacterial infections. Often combined with trimethoprim to form co-trimoxazole, it is prescribed for urinary tract infections, pneumonia, and specific protozoal infections. As antibiotic resistance escalates globally, understanding the current landscape of sulfamethoxazole—including ongoing clinical trials, market dynamics, and future projections—is essential for stakeholders across pharmaceutical, healthcare, and investment spheres.

Clinical Trials Landscape for Sulfamethoxazole

Current Clinical Trials and Research Focus

Recent years have seen a surge in clinical research centered on optimizing sulfamethoxazole therapy, addressing resistance, and expanding its indications. According to ClinicalTrials.gov, over 20 ongoing trials involve sulfamethoxazole, primarily focusing on:

  • Resistance Mitigation: Trials explore combination strategies, novel formulations, and dosing regimens to combat emerging bacterial resistance [1].
  • Expanded Use Cases: Studies investigate sulfamethoxazole's efficacy against multidrug-resistant organisms, including certain atypical bacteria and protozoal infections [2].
  • Drug Safety and Pharmacokinetics: Research aims to refine dosing in vulnerable populations, such as pediatrics and immunocompromised individuals [3].

Novel Formulations and Combination Strategies

Innovative formulations like slow-release tablets and intravenous versions are under evaluation to improve bioavailability and patient compliance. Additionally, research into dual therapies combining sulfamethoxazole with other antimicrobials aims to broaden therapeutic spectra and reduce resistance development.

Regulatory and Reimbursement Environment

While there are no recent indications of new FDA approvals specifically for sulfamethoxazole monotherapy, regulatory agencies are increasingly scrutinizing antibiotic use. Clinical trials emphasizing safety, resistance management, and real-world effectiveness advantage the drug’s future positioning [4].

Market Analysis of Sulfamethoxazole

Global Market Overview

The global antibiotics market, projected to reach USD 45.3 billion by 2027 at a CAGR of 3.9% (Grand View Research), encompasses sulfamethoxazole as a significant yet mature segment. Its market remains robust due to its longstanding use, especially in developing countries where infectious disease burden is high.

Key Market Drivers

  • High Prevalence of Urinary Tract Infections (UTIs): UTI management remains a primary driver, with sulfamethoxazole as a first-line or alternative treatment in many regions.
  • Rising Antibiotic Resistance: Resistance to penicillins and cephalosporins shifts prescribing preferences towards sulfonamides like sulfamethoxazole.
  • Generic Availability and Cost-Effectiveness: The widespread production and known safety profile keep the drug affordable, supporting sustained demand.

Regional Market Dynamics

  • North America: Market growth is plateauing due to resistance concerns and antimicrobial stewardship initiatives. Nonetheless, sulfamethoxazole maintains essential use in combination therapies.
  • Europe: Similar trends as North America, with increased focus on resistance management.
  • Asia-Pacific: Fastest growth segment, fueled by high infectious disease incidence, expanding healthcare infrastructure, and persistent reliance on generic antibiotics.
  • Emerging Markets: Availability and affordability sustain strong demand, though regulatory pressures and local resistance patterns influence utilization.

Competitive Landscape

Sulfamethoxazole is primarily supplied through generic formulations, with key players including Teva Pharmaceutical Industries, Mylan, and Sandoz. While no new brand-name drugs compete directly, the focus is on optimizing existing formulations and combination therapies.

Market Projection and Future Outlook

Factors Influencing Market Trajectory

  • Antimicrobial Resistance (AMR): Rising resistance could hinder sulfamethoxazole's efficacy, leading to reduced use in some indications.
  • Development of New Antibiotics: Introduction of novel agents and oral bacteriophages might overshadow traditional sulfonamides.
  • Regulatory and Stewardship Policies: Stricter guidelines aim to curtail unnecessary antibiotic use, impacting sales.

Forecasted Market Trends (2023–2030)

  • Steady Demand in Established Indications: Despite resistance concerns, sulfamethoxazole's role in combination therapies and niche indications is expected to remain stable.
  • Growth in Emerging Markets: Increased access and healthcare investments will propel sales, particularly in the Asia-Pacific region.
  • Innovation and Resistance Management: Clinical trial outcomes emphasizing resistance mitigation could revitalize interest, possibly leading to reformulations or combination innovations.

Quantitative Market Projection

Based on current trends, sulfamethoxazole market value is projected to grow modestly at a CAGR of around 2% over the next decade. The market in Asia-Pacific is anticipated to outperform others with a CAGR of 4%, driven by expanding healthcare access and infectious disease burden [5].

Key Challenges and Opportunities

Challenges

  • Antibiotic Resistance: Threatening the long-term efficacy and formulary relevance.
  • Competition from Newer Agents: Emergence of targeted antibiotics with better resistance profiles.
  • Regulatory Barriers: Stringent approval processes focusing on resistance and safety.

Opportunities

  • Combination Therapies: Developing fixed-dose combinations to enhance efficacy and reduce resistance.
  • Formulation Improvements: Novel delivery systems to improve pharmacokinetics.
  • Global Health Initiatives: Partnerships and subsidies for use in low-resource settings.

Key Takeaways

  • Clinical trials ongoing aim to refine sulfamethoxazole's use amid rising resistance, with particular emphasis on combination strategies, dosing, and safety.
  • The global market remains stable, with growth driven by high disease burden, particularly in emerging economies and in specific indications like UTIs.
  • Resistance challenges necessitate innovation, with future growth hinging on overcoming resistance hurdles and regulatory adaptations.
  • Sulfamethoxazole’s affordability and broad utility secure its niche, but competitive dynamics from emerging antibiotics and stewardship policies pose future risks.
  • Stakeholders should prioritize research into resistance management and formulation enhancements to maintain relevance in evolving healthcare landscapes.

FAQs

1. What are the main indications for sulfamethoxazole?
Sulfamethoxazole is primarily used to treat bacterial infections such as urinary tract infections, pneumonia, bronchitis, and certain protozoal infections, often in combination with trimethoprim.

2. Are there ongoing efforts to develop new formulations of sulfamethoxazole?
Yes. Clinical trials are exploring sustained-release formulations, IV options, and fixed-dose combination therapies to enhance efficacy, compliance, and resistance management.

3. How does antimicrobial resistance impact sulfamethoxazole’s market?
Rising resistance reduces the drug’s effectiveness, leading to decreased prescribing in some regions, although its continued utility in combination therapies sustains demand.

4. What is the outlook for sulfamethoxazole in emerging markets?
Strong growth is projected driven by expanding healthcare infrastructure, high infectious disease prevalence, and affordability factors, making these markets critical for future sales.

5. How might the future of sulfamethoxazole change with the development of new antibiotics?
Advances in targeted antibiotics and novel therapies could diminish reliance on sulfamethoxazole, emphasizing the importance of innovation and resistance management to preserve its role.


Sources:
[1] ClinicalTrials.gov. (2023). "Sulfamethoxazole Clinical Trials."
[2] WHO. (2021). "Global antimicrobial resistance surveillance."
[3] FDA. (2022). "Guidance on antimicrobial pharmacokinetics."
[4] European Medicines Agency. (2022). "Antibiotic resistance regulations."
[5] Grand View Research. (2022). "Antibiotics Market Analysis and Forecast."

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