Prospective randomized comparison of two prophylactic regimens with trimethoprim-sulfamethoxazole in leukemic children: a two year study

Rossi, Mario; Banfi, Patrizio; Cappuccilli, Marialuisa; Conter, Valentino; Poli, D.; Piacentini, Gabriella; Zurlo, Maria Grazia; Masera, Giuseppe

doi:10.1016/0277-5379(87)90449-4

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…Our study demonstrated that six months of DSS TMP-SMX regimen was more effective than TWDS TMP-SMX regimen for PJP prophylaxis in RTRs. Our result was different from previous studies published in the 1980s (10)(11)(12). Three studies published in the 1980s found no difference in the rate of PJP infections after daily vs thrice-weekly prophylaxis.…”

Section: Discussioncontrasting

confidence: 99%

Effectiveness and safety evaluation of thrice weekly double strength vs daily single strength trimethoprim-sulfamethoxazole for prophylaxis of pneumocystis jirovecii pneumonia after kidney transplantation: a two year prospective cohort study

Yang

Pang²,

Hu³

et al. 2021

J Pharm Pharm Sci

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Purpose: It is hard for clinicians to choose the best regimen for pneumocystis jirovecii pneumonia (PJP) prophylaxis. The aim is to evaluate the effectiveness and safety of thrice weekly double strength (TWDS) vs daily single strength (DSS) trimethoprim-sulfamethoxazole (TMP-SMX) for prophylaxis of PJP after kidney transplantation. Methods: Adult renal transplant recipients (RTRs) who were transplanted between January 1, 2015 and July 1, 2018 were evaluated. A total of 189 RTRs were prescribed PJP prophylactic regimen during the study period (TWDS group: n=98; DSS group: n=91). Results: Morbidity due to PJP infection was significantly higher in TWDS group as compared with DSS group (8.60% vs 1.14%, p= 0.021). There was a significant trend toward higher prevalence of confirmed PJP (log‐rank=0.021) in TWDS group. The use of DDS TMP-SMX for prophylaxis after kidney transplantation was associated with a 79% reduction in the incidence of PJP comparing the prophylactic regimen of TWDS. There was no significant difference between the two groups in the overall rate of premature TMP-SMX discontinuation and laboratory indexes. Conclusion: Six months of DSS TMP-SMX prophylaxis was more effective than TWDS TMP-SMX regimen with the same safety profile.

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Section: Discussioncontrasting

confidence: 99%

Effectiveness and safety evaluation of thrice weekly double strength vs daily single strength trimethoprim-sulfamethoxazole for prophylaxis of pneumocystis jirovecii pneumonia after kidney transplantation: a two year prospective cohort study

Yang

Pang²,

Hu³

et al. 2021

J Pharm Pharm Sci

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“…The optimal dose schedule for TMP‐SMX is not clear due to the limited number of studies comparing regimens in patients with malignancy or undergoing stem cell transplantation . Once‐ or twice‐weekly prophylaxis or 3 non‐consecutive days per week may be of equal efficacy, based on retrospective and observational studies (level III‐2 evidence) .…”

Section: Chemoprophylaxis For Pjpmentioning

confidence: 99%

Consensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014

Cooley

Dendle

Wolf

et al. 2014

Internal Medicine Journal

192

179

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Pneumocystis jirovecii infection (PJP) is a common cause of pneumonia in patients with cancer-related immunosuppression. There are well-defined patients who are at risk of PJP due to the status of their underlying malignancy, treatment-related immunosuppression and/or concomitant use of corticosteroids. Prophylaxis is highly effective and should be given to all patients at moderate to high risk of PJP. Trimethoprimsulfamethoxazole is the drug of choice for prophylaxis and treatment, although several alternative agents are available.

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“…TMP -SMX has been shown to be an effective prophylaxis in patients with cancer (Hughes et al, 1977). Daily and thrice weekly dosing regimens have demonstrated equivalence in patients with leukaemia (Hughes et al, 1987;Rossi et al, 1987), and twice weekly dosing has been shown to be effective in allogeneic transplant recipients (Souza et al, 1999).…”

Section: Trimethoprim -Sulfamethoxazole Prophylaxismentioning

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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Prospective randomized comparison of two prophylactic regimens with trimethoprim-sulfamethoxazole in leukemic children: a two year study

Cited by 14 publications

References 11 publications

Effectiveness and safety evaluation of thrice weekly double strength vs daily single strength trimethoprim-sulfamethoxazole for prophylaxis of pneumocystis jirovecii pneumonia after kidney transplantation: a two year prospective cohort study

Effectiveness and safety evaluation of thrice weekly double strength vs daily single strength trimethoprim-sulfamethoxazole for prophylaxis of pneumocystis jirovecii pneumonia after kidney transplantation: a two year prospective cohort study

Consensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014

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

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