Pneumocystis carinii pneumonia prophylaxis with atovaquone in trimethoprim-sulfamethoxazole-intolerant orthotopic liver transplant patients: a preliminary study.
Pneumocystis carinii pneumonia (PCP) is an opportunistic infection associated with increased morbidity and mortality in solid-organ and bone-marrow transplant recipients. Side effects of trimethoprim-sulfamethoxazole (TMP/SMX) are frequent; therefore, we performed a preliminary study using atovaquone suspension, 750 mg once daily, for 1 year for the prevention of PCP in liver transplant recipients intolerant to TMP/SMX therapy. Twenty-eight patients were treated, and data were analyzed for efficacy and toxicity. Adverse events occurred in 14 subjects, mainly related to the gastrointestinal tract. Side effects from TMP/SMX, i.e., rash, completely resolved and bone-marrow suppression improved in 62% of patients. No patients developed Pneumocystis carinii infection. Although a lower dose of atovaquone once daily may be effective in transplant recipients, further studies are necessary to confirm this preliminary observation. Liver Transpl 2001;7:750-751.)
Meyers
B
B
Transplant Infectious Diseases, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA. b_meyers@smtplink.mssm.edu
Borrego
F
F
Papanicolaou
G
G
D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D053626:Atovaquone; D001853:Bone Marrow / Q000187:drug effects; D003875:Drug Eruptions; D006801:Humans; D016031:Liver Transplantation; D009285:Naphthoquinones / Q000009:adverse effects / Q000627:therapeutic use*; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D011182:Postoperative Care; D011446:Prospective Studies; D019233:Retreatment; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
D000935:Antifungal Agents; D009285:Naphthoquinones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D053626:Atovaquone