 |
 |

Low-Dose Intermittent Trimethoprim-Sulfamethoxazole for Prevention of Pneumocystis carinii Pneumonia in Patients With Human Immunodeficiency Virus Infection
Gary P. Wormser, MD;
Harold W. Horowitz, MD;
Frederick P. Duncanson, MD;
Gilda Forseter, RN;
Kedarnath Javaly, MD;
Sudhir K. Alampur, MD;
Shelley A. Gilroy, MD;
Theodore Lenox, MD;
Ann Rappaport, RN, MPH;
Robert B. Nadelman, MD
Arch Intern Med. 1991;151(4):688-692.
Abstract
The important role of chemoprophylaxis for the prevention of Pneumocystis carinii pneumonia (PCP) in human immunodeficiency virus type 1 (HIV)—infected patients is undisputed. The most cost-effective regimen, however, is unknown. We reviewed our experience at two hospitals in the New York City area in which low-dose, intermittent therapy with the combination of trimethoprim and sulfamethoxazole was used to prevent PCP in HIVinfected patients. During a total of 202 months of primary prophylaxis in 32 patients and 319 months of secondary prophylaxis in 35 patients, PCP was diagnosed only once. More than 80% of patients were receiving zidovudine concomitantly. Adverse reactions to trimethoprim-sulfamethoxazole occurred in 31% and 52% of those receiving primary or secondary prophylaxis, respectively. When those patients who were considered ineligible to receive trimethoprim-sulfamethoxazole prophylaxis (Principally based on a prior adverse drug reaction) are also factored in, then approximately 50% of HIV-infected patients are candidates for long-term trimethoprim-sulfamethoxazole prophylaxis. The projected cost savings of this prophylaxis regimen, compared with those currently recommended by the US Public Health Service, are enormous.
(Arch Intern Med. 1991;151:688-692)
Author Affiliations
From the Division of Infectious Diseases and the Department of Medicine, Westchester County Medical Center (Drs Wormser, Horowtiz, and Nadelman), Metropolitan Hospital Center (Drs Duncanson and Lenox and Ms Rappaport), and New York Medical College (Drs Wormser, Horowitz, Duncanson, Javaly, Alampur, Gilroy, Lenox, and Nadelman and Ms Forseter), Valhalla.
Footnotes
Accepted for publication May 22, 1990.
Reprint requests to the Division of Infectious Diseases, Macy Pavilion, Room 209SE, New York Medical College, Valhalla, NY 10595 (Dr Wormser).
CiteULike Connotea Delicious Digg Facebook Reddit Technorati Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
 |
Is There a Role for Consensus Guidelines for P. jiroveci Pneumonia Prophylaxis in Immunosuppressed Patients with Rheumatic Diseases?
STAMP and HURST
The Journal of Rheumatology 2010;37:686-688.
FULL TEXT
Trimethoprim-Sulfamethoxazole (TMP-SMZ) Dose Escalation versus Direct Rechallenge for Pneumocystis Carinii Pneumonia Prophylaxis in Human Immunodeficiency Virus--Infected Patients with Previous Adverse Reaction to TMP-SMZ
Leoung et al.
The Journal of Infectious Disease 2001;184:992-997.
ABSTRACT
| FULL TEXT
Comparison of High and Low Doses of Trimethoprim-Sulfamethoxazole for Primary Prevention of Toxoplasmic Encephalitis in Human Immunodeficiency Virus-Infected Patients
Ribera et al.
Clinical Infectious Diseases 1999;29:1461-1466.
ABSTRACT
| FULL TEXT
Management of Adverse Reactions to Trimethoprim-Sulfamethoxazole in Human Immunodeficiency Virus--Infected Patients
Jung and Paauw
Arch Intern Med 1994;154:2402-2406.
ABSTRACT
Recommendations for Prophylaxis Against Pneumocystis carinii Pneumonia for Adults and Adolescents Infected With HIV
JAMA 1992;267:2294-2299.
Risk for Pneumothorax in AIDS
Northfelt and Safrin
ANN INTERN MED 1991;115:156-157.
ABSTRACT
|