Efficacy and toxicity of two doses of trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus. Dutch AIDS Treatment Group.
The efficacy and toxicity of trimethoprim-sulfamethoxazole (TMP-SMZ) as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with human immunodeficiency virus (HIV) infection was assessed by comparing the effects of two dosages (480 or 960 mg once a day) of the drug. The multicenter trial involved 260 HIV-infected patients with CD4 cell counts < 0.2 x 10(9)/L and no history of PCP. Patients were randomly assigned to the treatment groups. After a median follow-up of 376 days (range, 1-1219), none of the patients developed PCP. Most adverse reactions that required discontinuation were seen within the first month of TMP-SMZ use and were seen more frequently and earlier in the 960-mg group (hazard ratio, 1.4; 95% confidence interval, 0.95-2.02; P = .007). For patients with HIV infection, 480 mg of TMP-SMZ is as efficacious as but less toxic than 960 mg of the drug for primary prophylaxis against PCP.
Schneider
M M
MM
Department of Internal Medicine (Section of Immunology and Infectious Diseases), University Hospital Utrecht, Netherlands.
Nielsen
T L
TL
Nelsing
S
S
Hoepelman
A I
AI
Eeftinck Schattenkerk
J K
JK
van der Graaf
Y
Y
Kolsters
A F
AF
Borleffs
J C
JC
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D013420:Sulfamethoxazole / Q000008:administration & dosage*; D016019:Survival Analysis; D014123:Toxoplasmosis / Q000150:complications; D014295:Trimethoprim / Q000008:administration & dosage*
D014295:Trimethoprim; D013420:Sulfamethoxazole