A comparison of the effectiveness of three regimens in the prevention of Pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients

Martin, Mike; Cox, Patricia; Beck, Keith; Styer, Cathryn M.; Beall, Gildon N.

doi:10.1001/archinte.152.3.523

Cited by 26 publications

(18 citation statements)

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“…As demonstrated in HIV-infected patients (Martin et al, 1993;Warnock and Rimland, 1996;El-Sadr et al, 1998), alternative prophylactic agents may be used, but are associated with higher rates of failure. Dapsone prophylaxis (50 mg three times per week) in allogeneic transplant recipients has a significantly higher incidence of failure when compared to TMP -SMX (Souza et al, 1999).…”

Section: Alternative Agentsmentioning

confidence: 99%

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

et al. 2005

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Pneumocystis jirovecii pneumonia (PCP) is associated with high mortality in immunocompromised patients without human immunodeficiency virus infection. However, chemoprophylaxis is highly effective. In patients with solid tumours or haematologic malignancy, several risk factors for developing PCP have been identified, predominantly corticosteroid therapy. The aims of this study were to identify the potentially preventable cases of PCP in patients receiving corticosteroid therapy at a tertiary care cancer centre and to estimate the frequency of utilisation of chemoprophylaxis in these patients. Two retrospective reviews were performed. Over a 10-year period, 14 cases of PCP were identified: no cases were attributable to failed chemoprophylaxis, drug allergy or intolerance. During a 6-month period, 73 patients received high-dose corticosteroid therapy (X25 mg prednisolone or X4 mg dexamethasone daily) for X4 weeks. Of these, 22 (30%) had haematologic malignancy, and 51 (70%) had solid tumours. Fewer patients with solid tumours received prophylaxis compared to patients with haematologic malignancy (3.9 vs 63.6%, Po0.0001). Guidelines for PCP chemoprophylaxis in patients with haematologic malignancy or solid tumours who receive corticosteroid therapy are proposed. Successful primary prevention of PCP in this population will require a multifaceted approach targeting the suboptimal prescribing patterns for chemoprophylaxis.

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Section: Alternative Agentsmentioning

confidence: 99%

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

et al. 2005

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“…[6][7][8] However, adverse effects of trimethoprim-sulfamethoxazole may occur in as many as 50 percent of patients so treated, and 30 percent will need to change their regimen for this reason. 9,10 The alternatives include aerosolized pentamidine, dapsone with or without pyrimethamine, and atovaquone. 11, 12 The use of highly active antiretroviral therapy has changed the course of HIV infection, resulting in a striking reduction in morbidity and mortality.…”

Section: Resultsmentioning

confidence: 99%

A Randomized Trial of the Discontinuation of Primary and Secondary Prophylaxis againstPneumocystis cariniiPneumonia after Highly Active Antiretroviral Therapy in Patients with HIV Infection

Quirós

Miró

Peña³

et al. 2001

N Engl J Med

180

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“…However, among HIV-positive patients, pentamidine aerosol and dapsone have been shown to be less efficacious than TMP-SMX. 11 Failure of pentamidine aerosol as PCP prophylaxis in APBSCT recipients has been reported. 2,12 Our case also suggests that pentamidine inhalation may not be adequate for PCP prophylaxis in APBSCT, especially in patients treated with corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Pneumocystis carinii and cytomegalovirus pneumonia after autologous peripheral blood stem cell transplantation

Chuu

Catlett

Perry

et al. 1999

Bone Marrow Transplant

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Summary:A 46-year-old woman developed concurrent CMV and Pneumocystis carinii pneumonia (PCP) 140 days after autologous peripheral blood stem cell transplantation (APBSCT) for AML. She was seropositive for CMV before undergoing APBSCT and had required prednisone for immune thrombocytopenia and allergic dermatitis for 9 weeks prior to the onset of pneumonia. She had also been receiving PCP prophylaxis with pentamidine aerosol every month for 3 months before developing symptoms. The pneumonia was complicated by severe hypoxia, requiring ventilator support and pneumothorax requiring chest tube thoracostomy. She recovered following treatment with trimethoprim-sulfamethoxazole (TMP-SMX), prednisone, gancyclovir and intravenous immunoglobulin. Although the overall incidence of severe CMV disease is low after APBSCT, preventive measures such as surveillance culture and secondary prophylaxis with gancyclovir may be warranted in patients whose cellular immune response is further compromised by corticosteroid use or other factors.

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A comparison of the effectiveness of three regimens in the prevention of Pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients

Cited by 26 publications

References 0 publications

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

A Randomized Trial of the Discontinuation of Primary and Secondary Prophylaxis againstPneumocystis cariniiPneumonia after Highly Active Antiretroviral Therapy in Patients with HIV Infection

Concurrent Pneumocystis carinii and cytomegalovirus pneumonia after autologous peripheral blood stem cell transplantation

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