Trimetrexate and folinic acid: a valuable salvage option for Pneumocystis jirovecii pneumonia.
The best management strategy for HIV patients who fail to respond to first-line therapy for Pneumocystis jirovecii pneumonia is currently unclear. We identified all patients who were treated with trimetrexate and folinic acid who failed 7 or more days of cotrimoxazole, clindamycin-primaquine or dapsone-trimethoprim between 1996 and 2006. Trimetrexate was tolerated in 100% of cases with no treatment termination secondary to adverse drug reactions. Despite severe disease, 71% of patients were alive after 12 weeks.
Department of HIV/Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, UK. cshort@doctors.net.uk
Charlotte-Eve S
CE
Short
Yvonne C
YC
Gilleece
Martin J
MJ
Fisher
Duncan R
DR
Churchill
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome; D016597:Trimetrexate / Q000627:therapeutic use*
D000935:Antifungal Agents; D002955:Leucovorin; D016597:Trimetrexate