title: Prophylaxis of Pneumocystis carinii pneumonia with atovaquone in children with leukemia.
abstract: BACKGROUND
  Despite extensive studies of atovaquone in human immunodeficiency virus (HIV)-infected patients, there is little information about its efficacy as a prophylactic agent for Pneumocystis carinii pneumonia (PCP) in pediatric patients with cancer. Therefore, a retrospective analysis was conducted to determine the incidence of PCP in pediatric patients who received prophylactic atovaquone during treatment for acute leukemia.
  
  
  METHODS
  We reviewed the medical records of all patients treated at our institution for acute lymphoblastic leukemia or acute myeloid leukemia between 1994 and 2004. Only patients who were intolerant of trimethoprim-sulfamethoxazole (TMP-SMZ) and received atovaquone prophylaxis were included in the analysis.
  
  
  RESULTS
  Eighty-six patients were unable to tolerate TMP-SMZ and received daily atovaquone for PCP prophylaxis. PCP was not diagnosed in any patient who received atovaquone prophylaxis: the upper limit of the 95% confidence interval (CI) was 1.74 per 100 person-years.
  
  
  CONCLUSIONS
  Atovaquone is an efficacious alternative for PCP prophylaxis in pediatric patients who have leukemia and are intolerant of TMP-SMZ.
authors.affiliation: Division of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. renee.madden@stjude.org
authors.forename: Renee M
authors.initials: RM
authors.lastname: Madden
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Walter T
authors.initials: WT
authors.lastname: Hughes
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flynn
authors.forename: Wing
authors.initials: W
authors.lastname: Leung
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009894:Opportunistic Infections / Q000150:complications* / Q000517:prevention & control; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000276:immunology* / Q000517:prevention & control*; D012189:Retrospective Studies