Relationship of Sulfamethoxazole Therapeutic Drug Monitoring to Clinical Efficacy and Toxicity

Ice, Lauren L.; Barreto, Jason N.; Dao, Bao; Wolf, Robert C.; Dierkhising, Ross A.; Jannetto, Paul J.; Langman, Loralie J.; Tosh, Pritish K.

doi:10.1097/ftd.0000000000000282

Cited by 19 publications

(11 citation statements)

References 31 publications

(63 reference statements)

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“…Regarding the treatment of PJP, a multicenter retrospective study in Japan showed that a lower dose of TMP/SMX was as effective as higher doses of the same drug in patients with rheumatic diseases but was associated with fewer severe side effects. The role of therapeutic drug monitoring of TMP/SMX to reduce toxicity is still controversial 75,76 …”

Section: Resultsmentioning

confidence: 99%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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Systemic lupus erythematosus (SLE) is a more common autoimmune rheumatic disease in the Asia‐Pacific region. The prognosis of SLE remains unsatisfactory in some Asian countries because of delayed diagnosis, limited access to medications, increased complications and issues of tolerability and adherence to treatment. The Asia‐Pacific League of Associations for Rheumatology SLE special interest group has recently published a set of consensus recommendations on the management of SLE for specialists, family physicians, specialty nurses, and other healthcare professionals in the Asia‐Pacific region. This article reports a systematic literature review of the infective complications of SLE in Asia and evidence for prevention of these infections by pre‐emptive antimicrobial therapy and vaccination.

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Section: Resultsmentioning

confidence: 99%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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“…Sulfonamides and trimethoprim display concentration dependent killing (AUC/MIC) and should be administered after dialysis, when administered intravenously. TDM of sulfamethoxazole and its main metabolite may be considered, especially in dialysis patients who are treated for Pneumocystis jiroveci pneumonia (PJP) with high doses of co-trimoxazole [43]. …”

Section: Pharmacokinetics and Pharmacodynamics Of Anti-infective Agenmentioning

confidence: 99%

Optimization of anti-infective dosing regimens during online haemodiafiltration

Jager

Zandvliet

Touw

et al. 2017

Clinical Kidney Journal

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Online haemodiafiltration (HDF) is increasingly used in clinical practice as a routine intermittent dialysis modality. It is well known that renal impairment and renal replacement therapy can substantially affect the pharmacokinetic behaviour of several drugs. However, surprisingly few data are available on the need for specific dose adjustments during HDF. Due to convection, drug clearance may be increased during HDF as compared with standard haemodialysis. This may be of particular interest in patients undergoing anti-infective therapy, since under-dosing may compromise patient outcomes and promote the emergence of bacterial resistance. Drug clearance during HDF is determined by (i) dialysis characteristics, (ii) drug characteristics and (iii) patient characteristics. In this review, we will discuss these different determinants of drug clearance during HDF and advise on how to adjust the dose of antibacterial, antimycotic and antiviral agents in patients undergoing HDF. In addition, the possible added value of therapeutic drug monitoring is discussed. The review provides guidance for optimization of anti-infective dosing regimens in HDF patients.

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“…Hence, the decision for prophylaxis should be individualized and the benefits of administering prophylaxis should always be balanced against the risks . Trimethoprim/sulfamethoxazole, the recommended agent for anti‐ Pneumocystis prophylaxis, is not without adverse events including myelosuppression, renal impairment, hyperkalemia, transaminitis, and hyperbilirubinemia . Furthermore, allergic reactions and additional pill burden can also contribute to morbidity.…”

Section: Discussionmentioning

confidence: 99%

Low incidence of pneumocystis pneumonia utilizing PCR‐based diagnosis in patients with B‐cell lymphoma receiving rituximab‐containing combination chemotherapy

et al. 2016

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Recent literature has demonstrated concern over the risk of Pneumocystis jirovecii pneumonia (PJP) when administering rituximab with combination chemotherapy such as in R-CHOP; however, the exact risk and potential need for prophylaxis is unknown. We sought to determine the incidence of PJP infection following R-CHOP administration in patients with B-cell lymphoma. Consecutive patients diagnosed with B-cell lymphoma receiving R-CHOP were evaluated from chemotherapy initiation until 180 days after the last administration. The primary outcome was cumulative incidence of PJP infection. Secondary endpoints included the association of rituximab, prednisone and subsequent chemotherapy with PJP infection risk. A total of 689 patients (53% male, median age 66 years) were included. Seventy-three percent of patients completed at least 6 cycles of R-CHOP treatment. Median rituximab and prednisone cumulative doses were 3950 mg and 5325 mg, respectively. Median daily prednisone dose through end of treatment was 45 mg (range 7.6 mg to 119 mg). The cumulative incidence of PJP was 1.51% (95% CI 0.57-2.43, at maximum follow-up of 330 days), below 3.5%, the conventional threshold for prophylaxis. Univariate analysis did not detect a statistically significant association between PJP and rituximab, steroids, or receipt of additional chemotherapy in this patient population. Our results demonstrate a low occurrence of Pneumocystis pneumonia during R-CHOP treatment of B-cell lymphoma and argue against universal anti-Pneumocystis prophylaxis in this setting. Further investigations should focus on targeted anti-Pneumocystis prophylaxis for patients presenting with high-risk baseline characteristics or when receiving rituximab-inclusive intensive combination chemotherapy regimens as treatment for other aggressive lymphoma subtypes. Am. J. Hematol. 91:1113-1117, 2016. © 2016 Wiley Periodicals, Inc.

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Relationship of Sulfamethoxazole Therapeutic Drug Monitoring to Clinical Efficacy and Toxicity

Cited by 19 publications

References 31 publications

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Optimization of anti-infective dosing regimens during online haemodiafiltration

Low incidence of pneumocystis pneumonia utilizing PCR‐based diagnosis in patients with B‐cell lymphoma receiving rituximab‐containing combination chemotherapy

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