PMID: 6981177Mar 1, 1982Paper

Trimethoprim-sulfamethoxazole in the treatment of adults with pneumonia due to Pneumocystis carinii

Reviews of Infectious Diseases
L S Young

Abstract

The use of trimethoprim-sulfamethoxazole (TMP-SMZ) for the treatment of pneumonia due to Pneumocystis carinii has not been as rigorously assessed in studies of adults as in pediatric studies that have included patients randomly assigned to receive either pentamidine or TMP-SMZ. Nonetheless, it was shown that 80% of adults with histologically proved pneumocystis pneumonia who were treated with TMP-SMZ intravenously for at least four days or orally for at least nine days (total daily dose, 10-20 mg/kg) responded clinically and radiologically. Recipients of organ transplants and patients with lymphomas or lymphatic leukemia predominated in these studies. The median time to improvement was four days. TMP-SMZ therapy was continued for up to six days before a change to pentamidine was considered. Clinical failures of treatment were associated with delayed diagnosis and initiation of treatment, poor absorption of the orally administered drug, and concomitant life-threatening infections. Thus, a regimen involving initial intravenous therapy with doses of 15-20 mg/kg per day, with subsequent reduction of dosage or change to oral medication if improvement is rapid, was developed. With large initial intravenous doses, the monitoring of dr...Continue Reading

Citations

Sep 1, 1985·Diagnostic Microbiology and Infectious Disease·M S BartlettJ W Smith
Dec 3, 1983·Lancet·M T NutiniF Tron
Jun 1, 1995·Journal of Clinical Pharmacy and Therapeutics·A E Jolley, J G Hastings
Dec 1, 1985·Antimicrobial Agents and Chemotherapy·M T CushionP D Walzer
Sep 1, 1988·Postgraduate Medical Journal·R J McGonigleD Adu
May 15, 1984·The American Journal of Medicine·L S Young
Sep 1, 1989·DICP : the Annals of Pharmacotherapy·C M Paap, M C Nahata
Aug 3, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Alessio StrazzullaSylvain Diamantis

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