Mycophenolate mofetil may protect against Pneumocystis carinii pneumonia in renal transplanted patients.
Pneumocystis carinii pneumonia (PCP) is usually prevented in transplanted patients by prophylactic trimethoprim-sulfamethoxazol (TMS). Mycophenolate mofetil (MMF) has been shown to have a strong protective effect against PCP in rats. This effect is also suggested in humans by the absence of PCP in patients receiving MMF. After January 1998 MMF has been used with no TMS prophylaxis in renal transplanted patients. In azathioprine (AZA) treated patients TMS prophylaxis was maintained. The incidence of PCP was analyzed in both groups. Data were collected in order to have a minimum 6-month follow-up. Two hundred and seventy-two patients were eligible for analysis. No PCP occurred either in patients under MMF without TMS prophylaxis nor in patients under AZA. MMF may have an effective protective role against PCP as no patient under MMF, despite not receiving TMS coverage, developed PCP. A larger, controlled, trial is warranted to consolidate this information.
Azevedo
Luiz Sergio
LS
Renal Transplantation Unit, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil. ls.azevedo@terra.com.br
Castro
Maria Cristina R
MC
Paula
Flavio J
FJ
Ianhez
Luiz Estevam
LE
David-Neto
Elias
E
D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid