Abstract |
Pneumocystis jirovecii pneumonia (PCP) in human immunodeficiency virus (HIV)-infected patients is usually treated with trimethoprim ( TMP)- sulfamethoxazole (SMX) 1920 mg 3 times daily (approximately equivalent to TMP 15 mg/kg/day-SMX 75 mg/kg/day) for 21 days. Pharmacokinetic data suggest that lower doses would be equally efficacious and might be associated with a lower incidence of adverse effects. We conducted a retrospective review of case notes for the first episode of laboratory-confirmed PCP in HIV-infected patients treated at Auckland City Hospital, from January 1991 through December 2007. Seventy-three of 84 (87%) patients were treated with TMP-SMX 960 mg 4 times daily or 3 times daily (approximately TMP 10 mg/kg/day-SMX 50 mg/kg/day). The overall mortality was 5/73 (7%). The mortality in patients with severe disease (transcutaneous oxygen saturation on admission < or =84%) was 3/16 (19%) and in patients admitted to the intensive care unit was 5/9 (56%). Fifteen of 73 (21%) patients required a change to an alternative treatment regimen because of adverse effects ( rash in 10, rash plus fever in 3, neutropenia in 1, fever plus headache in 1). Treatment of PCP in adult HIV-infected patients with TMP-SMX 960 mg QID or TID appears to have comparable efficacy to treatment with higher doses and to be associated with a lower rate of treatment limiting adverse effects.
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Authors | Mark Thomas, Priscilla Rupali, Andrew Woodhouse, Rod Ellis-Pegler |
Journal | Scandinavian journal of infectious diseases
(Scand J Infect Dis)
Vol. 41
Issue 11-12
Pg. 862-8
( 2009)
ISSN: 1651-1980 [Electronic] England |
PMID | 19922070
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Infective Agents
- Trimethoprim, Sulfamethoxazole Drug Combination
- Sulfamethoxazole
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Topics |
- AIDS-Related Opportunistic Infections
(blood, drug therapy, microbiology)
- Adult
- Aged
- Anti-Infective Agents
(administration & dosage)
- Female
- HIV Infections
(blood, microbiology)
- Humans
- Logistic Models
- Male
- Middle Aged
- Pneumocystis carinii
- Pneumonia, Pneumocystis
(blood, drug therapy, virology)
- Retrospective Studies
- Sulfamethoxazole
(blood)
- Treatment Outcome
- Trimethoprim, Sulfamethoxazole Drug Combination
(administration & dosage)
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