Utility of dapsone for prophylaxis of Pneumocystis carinii pneumonia in trimethoprim-sulfamethoxazole-intolerant, HIV-infected individuals.
OBJECTIVE
To determine the safety and efficacy of 100 mg dapsone three times weekly for Pneumocystis carinii pneumonia (PCP) prophylaxis in HIV-infected, trimethoprim-sulfamethoxazole (TMP-SMX)-intolerant patients.


METHODS
Retrospective chart review of patients followed-up to 22 May 1992.


METHODS
Infectious diseases outpatient clinic of a tertiary care center in suburban New York City.


METHODS
Twenty-three HIV-infected patients requiring PCP prophylaxis with documented intolerance to TMP-SMX.


METHODS
Patients were followed clinically and with laboratory testing at approximately monthly intervals.


RESULTS
Dapsone was discontinued in nine (39%) patients because of adverse reactions. All reactions occurred within the first 2 months of treatment. Two (14%) of the remaining 14 patients developed histologically proven PCP over 126 patient-months of follow-up.


CONCLUSIONS
Approximately 40% of TMP-SMX-intolerant HIV-infected individuals are also intolerant of dapsone. Prophylaxis failures may be expected on a dose regimen of 100 mg dapsone three times weekly. More experience with other dose regimens and alternative agents is needed.
Jorde
U P
UP
Department of Medicine, New York Medical College, Valhalla 10595.
Horowitz
H W
HW
Wormser
G P
GP
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000517:prevention & control*; D000328:Adult; D000075202:Contraindications; D003622:Dapsone / Q000009:adverse effects / Q000627:therapeutic use*; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D005334:Fever / Q000139:chemically induced; D005978:Glutathione / Q000172:deficiency; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003622:Dapsone; D005978:Glutathione