PMID: 8604455Mar 1, 1996Paper

Options in the management of pneumonia caused by Pneumocystis carinii in patients with acquired immune deficiency syndrome and intolerance to trimethoprim/sulfamethoxazole

Southern Medical Journal
H Korraa, C Saadeh

Abstract

The increased resistance, intolerance, or allergy to trimethoprim/sulfamethoxazole (TMP/SMX) has brought much attention to alternative treatment of pneumonia caused by Pneumocystis carinii (PCP). Pentamidine is considered when there is documented allergy or intolerance to TMP/SMX. Similarly, either dapsone/trimethoprim or clindamycin/primaquine is effective in the treatment of mild to moderate PCP, but both regimens are contraindicated in glucose 6-phosphate dehydrogenase (G6PD) deficiency. For this purpose, atovaquone should be used in patients who are deficient in G6PD or who are unable to be on TMP/SMX or pentamidine. On the other hand, in severe disease, adjunctive corticosteroids can enhance the efficacy of either TMP/SMX or pentamidine. If these therapies yield no response, trimetrexate with leucovorin has been approved as initial and salvage therapy in severe PCP. We review alternative treatment to TMP/SMX and propose ideal and practical therapeutic and prophylactic guidelines in the treatment and prevention of PCP.

Citations

Mar 7, 2008·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Donald A Dibbern, Anthony Montanaro
Mar 11, 2000·Pharmacotherapy·G C Wood, B A Boucher
Nov 19, 2008·Journal of the Chinese Medical Association : JCMA·Hung ChangMing-Hsun Lee
Jun 19, 2004·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Matthew W Hruska, Reginald F Frye
Aug 21, 2001·Journal of the American Academy of Dermatology·Y I Zhu, M J Stiller
Jan 15, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Pierre O SellierJean-François Bergmann
Apr 5, 2019·Expert Opinion on Drug Metabolism & Toxicology·Elisa MolinelliAnnamaria Offidani
Nov 4, 2009·Scandinavian Journal of Infectious Diseases·Emmanuel E DouzinasAlex P Betrosian

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