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Successful chemoprophylaxis for pneumocystis with dapsone or bactrim.

Metroka CE, Jacobus D, Lewis N; International Conference on AIDS.

Int Conf AIDS. 1989 Jun 4-9; 5: 196 (abstract no. T.B.O.4).

St. Luke's/Roosevelt Hospital Center, New York, NY, USA

OBJECTIVE: An open study of the efficacy and tolerance of dapsone or bactrim in the prevention of pneumocystis (PCP). METHODS: We studied 221 patients (pts) who were at high risk for PCP from 4/85 to 6/88 and received prophylaxis. All pts had either less than 250 T4+ cells/mm3, severe constitutional symptoms (17 pts), or a prior opportunistic infection (OI). RESULTS: The mean T4+ cells at the time of treatment initiation was 142 (range, 9 to 573). 173 pts received dapsone (avg 9.4 mos, range up to 43 mos) and 48 pts received bactrim (avg 8.2 mos, range up to 57 mos). 2/173 pts receiving dapsone 25 mg qid and 0/48 pts receiving bactrim ds 1 tab bid developed PCP (9=0.37, NS). In contrast, 26 episodes of PCP occurred in 23 pts who refused prophylaxis (avg 9.6 mos, range up to 29 mos). 10% of pts receiving dapsone and 38% of pts receiving bactrim prophylaxis experienced an adverse reaction (p less than 0.0001). Pts hypersensitive to 1 drug generally tolerated the other. 1/29 pts receiving both dapsone and AZT had to be withdrawn from dapsone because of a sustained drop in Hct. 15 pts developed Kaposi's Sarcoma while receiving dapsone. No pts receiving dapsone developed cryptosporidiosis. 125 pts receiving dapsone and 20 pts receiving bactrim developed other OI or malignancies; 89 pts on dapsone and 8 pts on bactrim have died. CONCLUSIONS: Both dapsone and bactrim are equally effective in preventing PCP but a higher percentage of pts receiving bactrim experienced adverse reactions.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Animals
  • Dapsone
  • Humans
  • Pneumocystis
  • Pneumocystis Infections
  • Pneumonia, Pneumocystis
  • Trimethoprim-Sulfamethoxazole Combination
  • Zidovudine
Other ID:
  • 00082389
UI: 102176714

From Meeting Abstracts




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