Co-trimoxazole in patients with haematological malignancies: a review of 10-years' clinical experience.
Co-trimoxazole has been used in a hospital for over 10 years as a major antibacterial agent in the treatment of malignant haematological diseases. Routine selective gut decontamination with co-trimoxazole combined with colistine and an antifungal agent has led to a reduction in infections in neutropenic patients from 40% to 25% since the strategy was adopted, and this had been accompanied by a change in the most frequent pathogens, from Gram-negative to Gram-positive organisms. Co-trimoxazole has proved to be the drug of choice for Pneumocystis carinii infections. Finally, it is used as first-line therapy in febrile immunosuppressed patients who are not on selective decontamination, with an efficacy of over 90%. Apart from mild abdominal discomfort, an elevated allergy rate of 14% in patients with overt leukaemia is a major disadvantage. On the other hand, substantial prolongation of episodes of bone marrow aplasia has not been observed.
De Pauw
B E
BE
Department of Internal Medicine, University Hospital St. Radboud, Nijmegen, The Netherlands.
Novakova
I R
IR
Ubachs
E
E
Hoes
A
A
Stalpers
L
L
Verhagen
C
C
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007422:Intestines / Q000382:microbiology; D007938:Leukemia / Q000150:complications / Q000382:microbiology*; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control*; D013420:Sulfamethoxazole / Q000009:adverse effects / Q000627:therapeutic use*; D014295:Trimethoprim / Q000009:adverse effects / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D000890:Anti-Infective Agents; D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole