Trimethoprim-Sulfamethoxazole for the Treatment of Pneumocystis carinii Pneumonia

doi:10.1059/0003-4819-92-6-762

Trimethoprim-Sulfamethoxazole for the Treatment of Pneumocystis carinii Pneumonia

DREW J. WINSTON, M.D.;
WILLIAM K. LAU, M.D.;
ROBERT PETER GALE, M.D., Ph.D.; and
LOWELL S. YOUNG, M.D.

Los Angeles, California

Excerpt

Intravenous trimethoprim-sulfamethoxazole therapy was evaluated in 11 consecutive patients with documented Pneumocystis carinii pneumonia and the results compared to those from previously published studies of trimethoprim-sulfamethoxazole therapy for P. carinii pneumonia. Although six patients needed mechanical ventilation, intravenous therapy was successful in seven of 11 patients (64%), and seven of nine patients (78%) receiving 4 or more days of intravenous trimethoprim-sulfamethoxazole therapy were cured. Side effects occurred in two patients (skin rash in one, nausea and vomiting in one). A review of 80 reported cases of confirmed P. carinii pneumonia initially treated with trimethoprim-sulfamethoxazole alone revealed response rates of 67.5% in all treated patients and 85.5% in patients treated for 9 or more days. The clinical response was similar in adults (63.2%) and children (68.9%). Side effects were noted in only 11 of 80 patients (13.8%). Compared to pentamidine, trimethoprim-sulfamethoxazole has a narrower toxic-therapeutic ratio and should be preferred treatment for P. carinii pneumonia in adults as well as children.

This 100-word excerpt has been provided in the absence of an abstract.

Acknowledgments

ACKNOWLEDGMENTS: The authors thank Dr. Rayburn B. Vrabel, Chief, Drug Information Service, UCLA Center for the Health Sciences, Los Angeles, California, for his valuable assistance in preparing this manuscript.

Article and Author Information

▸From the Divisions of Infectious Diseases and Hematology-Oncology, Department of Medicine, and the Center for Interdisciplinary Research in Immunological Diseases, University of California at Los Angeles, The Center for the Health Sciences; Los Angeles, California.
Grant support: by a Research Grant from Hoffmann-LaRoche, Inc. , Nutley, New Jersey; Grants CA-23175 and CA-15688 from the National Cancer Institute; Grant HB-62971 from the National Heart, Lung, and Blood Institute; and Grant AI-15332 from the National Institute of Allergy and Infectious Diseases. Dr. Gale is a Scholar of the Leukemia Society of America.
▸Requests for reprints should be addressed to Drew J. Winston, M.D.; Division of Infectious Diseases, UCLA Center for the Health Sciences; Los Angeles, CA 90024.
- Received October 11, 1979.
- Accepted February 19, 1980.