title: Gastrointestinal damage induced by cytostatic treatment does not affect the bioavailability of co-trimoxazole.
abstract: Twelve lymphoma patients received prophylaxis with co-trimoxazole during cytostatic treatment according to the MACOP-B regimen with cyclophosphamide, doxorubicin, vincristine, methotrexate, bleomycin, folinic acid and prednisone. Gastrointestinal mucosal damage from cytostatic treatment was estimated by WHO toxicity scores. No correlation was found between the degree of gastrointestinal damage and the presumed bioavailability of co-trimoxazole as estimated from serum levels of trimethoprim and sulphamethoxazole. The serum concentrations were above the minimum inhibitory concentration for Escherichia coli, Staphylococcus aureus and coagulase-negative staphylococci irrespective of the degree of toxicity. There is no apparent reason to change the dosing regimen of prophylactic co-trimoxazole when there is clinical evidence of damage to the gastrointestinal mucosa induced by chemotherapy.
authors.affiliation: Department of Infectious Diseases, University Hospital, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Nyhlén
authors.forename: A
authors.initials: A
authors.lastname: Johnsson
authors.forename: P
authors.initials: P
authors.lastname: Höglund
authors.forename: B
authors.initials: B
authors.lastname: Ljungberg
authors.forename: I
authors.initials: I
authors.lastname: Nilsson-Ehle
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000493:pharmacokinetics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001682:Biological Availability; D001761:Bleomycin / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects; D004064:Digestive System / Q000187:drug effects* / Q000378:metabolism; D004317:Doxorubicin / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects; D008223:Lymphoma / Q000188:drug therapy; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000493:pharmacokinetics*; D014750:Vincristine / Q000009:adverse effects
chemical_list: D000890:Anti-Infective Agents; D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003520:Cyclophosphamide; D002955:Leucovorin; D011241:Prednisone; D008727:Methotrexate