The influence of PCP prophylaxis on bacteriuria incidence and resistance development to trimethoprim/sulfamethoxazole in HIV-infected patients.
BACKGROUND
Earlier studies have shown that men infected with HIV-1 and a CD4+ cell count below 200 mm3 are at increased risk for bacteriuria. We studied the effect of 3 Pneumocystis carinii (PCP) prophylaxis regimens (low-dose TMP/SMZ, high-dose TMP/SMZ and pentamidine aerosol) on the incidence of bacteriuria and resistance development to TMP/SMZ.


METHODS
Retrospective analysis of 103 HIV-positive patients.


RESULTS
Nine patients using pentamidine had a positive culture (32%), compared to 9 patients using low-dose TMP/SMZ (17%) and 5 patients using high-dose TMP/SMZ (22%). These differences were not significant (P = 0.207). However, almost all episodes in patients using TMP/SMZ were due to infection with a resistant strain.


CONCLUSIONS
PCP prophylaxis with trimethoprim/sulfamethoxazole does not significantly influence the rate of bacteriuria, probably due to the development of resistance.
van Dooyeweert
D A
DA
Department of Medicine, University Hospital Utrecht, Netherlands.
Schneider
M M
MM
Borleffs
J C
JC
Hoepelman
A I
AI
D001437:Bacteriuria / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*
D014295:Trimethoprim; D013420:Sulfamethoxazole