LOW-DOSE DAPSONE PROPHYLAXIS OF PNEUMOCYSTIS-CARINII PNEUMONIA IN AIDS AND AIDS-RELATED COMPLEX

被引:62
作者
KEMPER, CA
TUCKER, RM
LANG, OS
KESSINGER, JM
GREENE, SI
DERESINSKI, SC
STEVENS, DA
机构
[1] SANTA CLARA VALLEY MED CTR,DEPT MED,DIV DERMATOL,SAN JOSE,CA 95128
[2] SANTA CLARA VALLEY MED CTR,DEPT MED,AIDS PROGRAM,SAN JOSE,CA 95128
[3] CALIF INST MED RES,SAN JOSE,CA
[4] STANFORD UNIV,MED CTR,SCH MED,DEPT MED,DIV INFECT DIS,STANFORD,CA 94305
[5] STANFORD UNIV,MED CTR,SCH MED,DEPT DERMATOL,STANFORD,CA 94305
关键词
aerosolized pentamidine; AIDS; dapsone; glucose-6-phosphate dehydrogenase; methemoglobin; Pneumocystis carinii pneumonia; prophylaxis;
D O I
10.1097/00002030-199011000-00015
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The efficacy, toxicity and cost of orally administered dapsone (50-100 mg/day) for prophylaxis of Pneumocystis carinii pneumonia (PCP) were evaluated in 30 patients with AIDS or AIDS-related complex (ARC). Six patients received primary and 24 secondary prophylaxis. Ten patients received a maximum dose of 100 mg/day and 20 a maximum of 50 mg/day for a median duration of 19 weeks; 22 of the 30 patients continue to receive prophylaxis as of May 1989. Four patients have died, none of pneumocystis infection. One patient with AIDS suffered a mild relapse while receiving 50 mg/day. Hematologic toxicity was mild and could not be definitively attributed to dapsone therapy; rash due to dapsone was documented in two patients. A review of 33 patients at our institution with a history of PCP who received no prophylaxis demonstrated seven relapses, three of which were fatal. Cost analysis revealed a significant advantage for oral dapsone over aerosolized pentamidine.
引用
收藏
页码:1145 / 1148
页数:4
相关论文
共 24 条
[1]   INTERACTION OF SULFONAMIDE AND SULFONE COMPOUNDS WITH TOXOPLASMA-GONDII DIHYDROPTEROATE SYNTHASE [J].
ALLEGRA, CJ ;
BOARMAN, D ;
KOVACS, JA ;
MORRISON, P ;
BEAVER, J ;
CHABNER, BA ;
MASUR, H .
JOURNAL OF CLINICAL INVESTIGATION, 1990, 85 (02) :371-379
[2]  
BASKIN MI, 1989, AM REV RESPIR DIS, V139
[3]  
CONKLING PR, 1986, N C MED J, V47, P109
[5]   RECENT ADVANCES IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF PNEUMOCYSTIS-CARINII PNEUMONIA [J].
DAVEY, RT ;
MASUR, H .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1990, 34 (04) :499-504
[6]   SAFETY AND EFFICACY OF SULFAMETHOXAZOLE AND TRIMETHOPRIM CHEMOPROPHYLAXIS FOR PNEUMOCYSTIS-CARINII PNEUMONIA IN AIDS [J].
FISCHL, MA ;
DICKINSON, GM ;
LAVOIE, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1988, 259 (08) :1185-1189
[7]  
GIRARD PM, 1989, LANCET, V1, P1348
[8]  
GOLDEN JA, 1989, LANCET, V1, P654
[9]  
GROSSMAN SJ, 1988, J PHARMACOL EXP THER, V244, P118
[10]  
HARDY WD, 1989, AM J MED, V87, P329, DOI 10.1016/S0002-9343(89)80159-7