Dapsone-trimethoprim for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome

• Published in: Annals of internal medicine Vol. 105; no. 1; p. 45
• Main Authors: Leoung, G S, Mills, J, Hopewell, P C, Hughes, W, Wofsy, C
• Format: Journal Article
• Language: English
• Published: United States 01.07.1986
• Subjects: Acquired Immunodeficiency Syndrome - complications; Bronchoscopy; Dapsone - administration & dosage; Dapsone - adverse effects; Dapsone - therapeutic use; Drug Eruptions - etiology; Drug Therapy, Combination; Fever - therapy; Hematocrit; Humans; Liver - enzymology; Nausea - chemically induced; Pneumonia, Pneumocystis - drug therapy; Pneumonia, Pneumocystis - etiology; Respiratory Function Tests; Sputum - parasitology; Trimethoprim - administration & dosage; Trimethoprim - adverse effects; Trimethoprim - therapeutic use
• ISSN: 0003-4819
• DOI: 10.7326/0003-4819-105-1-45

All patients with the acquired immunodeficiency syndrome and a first episode of Pneumocystis carinii pneumonia seen at the San Francisco General Hospital between November 1984 and April 1985 were evaluated for oral treatment with dapsone (100 mg/d) plus trimethoprim (20 mg/kg body weight X d). All 15 patients who met the entry criteria improved clinically and radiographically within 3 to 10 days after starting treatment. Repeat pulmonary function tests and gallium lung scans after 3 weeks of therapy also showed improvement. Although side effects occurred in 14 patients, in only 2 were they severe enough to require stopping therapy. Both of these patients had worsening skin rash, and dapsone-trimethoprim therapy was stopped after 10 days. When compared with trimethoprim-sulfamethoxazole or pentamidine used to treat P. carinii pneumonia in similar patients, oral dapsone-trimethoprim is at least as effective, seems to be better tolerated, and may have a lower frequency of serious side effects.