title: Comparison of trimethoprim-sulfamethoxazole, dapsone, and pentamidine in the prophylaxis of Pneumocystis carinii pneumonia.
abstract: OBJECTIVE
  To compare the incidence of Pneumocystis carinii pneumonia (PCP) in patients infected with the human immunodeficiency virus (HIV) receiving one of three prophylactic agents.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  A university-affiliated Department of Veterans' Affairs medical center HIV clinic.
  
  
  METHODS
  All 200 HIV-infected patients enrolled in the clinic who were prescribed a PCP prophylactic drug during 18 months.
  
  
  METHODS
  Patients were administered oral trimethoprim-sulfamethoxazole (TMP-SMX) DS, oral dapsone, or aerosolized pentamidine in a heirarchic fashion. A subset of 110 patients received only one of the prophylaxis regimens for at least 6 months; they were examined separately for the purpose of statistical analysis.
  
  
  RESULTS
  One case of PCP was diagnosed in 1110 patient-months of oral TMP-SMX DS therapy, 6 in 418 patient-months of oral dapsone therapy, and 3 in 164 patient-months of aerosolized pentamidine therapy. In the subset population, the documented incidence of PCP was 0% among 71 TMP-SMX DS-treated patients, 16% among 25 dapsone-treated patients (p < 0.004), and 14% among 14 aerosolized pentamidine-treated patients (p < 0.03). For patients receiving primary prophylaxis, the incidence of PCP was 0% for 58 receiving TMP-SMX, 15% for 20 receiving dapsone (p = 0.015), and 17% for 6 receiving pentamidine (p = 0.094).
  
  
  CONCLUSIONS
  We believe TMP-SMX DS was more effective than oral dapsone or aerosolized pentamidine in preventing PCP in these HIV-infected patients.
authors.affiliation: Department of Pharmacy Practice, Mercer University Southern School of Pharmacy, Atlanta, Georgia 30341, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Warnock
authors.forename: D
authors.initials: D
authors.lastname: Rimland
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003622:Dapsone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010419:Pentamidine / Q000627:therapeutic use*; D011010:Pneumocystis; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D012189:Retrospective Studies; D014122:Toxoplasma; D014123:Toxoplasmosis / Q000517:prevention & control; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D010419:Pentamidine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003622:Dapsone