Prophylaxis of Pneumocystis carinii pneumonia with atovaquone in children with leukemia.
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.
Madden
Renee M
RM
Division of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. renee.madden@stjude.org
Pui
Ching-Hon
CH
Hughes
Walter T
WT
Flynn
Patricia M
PM
Leung
Wing
W
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