Low-dose intermittent trimethoprim-sulfamethoxazole for prevention of Pneumocystis carinii pneumonia in patients with human immunodeficiency virus
Article Abstract:
Up to 75 percent of patients with AIDS will develop the infection Pneumocystis carinii pneumonia, or PCP. Treatment of PCP consists of either pentamidine or trimethoprim-sulfamethoxazole (TMP-SMX). Studies have been done to find a method to prevent PCP, in addition to treating it. In other patients with compromised immune systems, such as those with cancer or those who have received transplants, TMP-SMX given daily or several times per week has proven to be beneficial to prevent the disease. Few studies have been done thus far to show if TMP-SMX is effective in preventing PCP in AIDS patients. TMP-SMX was given orally every other day to two groups of AIDS patients. One group received the drug as primary prophylaxis, having never had PCP. The second group was given the drug as secondary prophylaxis, in that they had already had PCP and the drug was administered in the hopes of preventing recurrence. Of the patients given TMP-SMX as primary prophylaxis, none developed PCP during the time of the study, while three (31 percent) had the drug discontinued due to adverse reactions. The patients given TMP-SMX had a much higher incidence of adverse reactions, as 52 percent of them had to discontinue the drug before the study period was over. Of those who were able to tolerate the drug, only one of 27 patients developed PCP. The greater incidence of adverse reactions in the group receiving secondary prophylaxis might be attributable to the fact that most of them had been treated previously with TMP-SMX for their first episodes of PCP. Given that the existing drug recommended for PCP prophylaxis is pentamidine in an aerosol form, which costs over $100 per month, and that TMP-SMX costs approximately $1.20 per month, TMP-SMX should be the drug of choice in those who can tolerate it without adverse effects. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Staphylococcus epidermidis extracted slime inhibits the antimicrobial action of glycopeptide antibiotics
Article Abstract:
Coagulase-negative staphylococci bacteria have usually been considered to be pathogenic contaminants. Recently, their role in infection has increased, especially in association with prosthetic devices. These bacteria are principally methicillin-resistant, and vancomycin is the antibiotic of choice in the treatment of infections due to coagulase-negative staphylococci. Some strains of coagulase-negative Staphylococcus epidermidis (SE) produce an extracellular slime-like material which appears to be associated with the virulence of these organisms. Eight slime-producing isolates of SE were obtained and grown in chemically defined media. Crude slime filtrates were separated, purified and a common polysaccharide was characterized. This slime polysaccharide is believed to be associated with promoting the adherence of the bacteria to catheters and other foreign bodies, and may also be responsible for the resistance to vancomycin and related antibiotics. Further, the polysaccharide may contribute to the failure of these antibiotics to treat foreign body-related infections. The presence of the polysaccharide extract increased the minimal inhibitory concentrations (MIC; dose-response relationship) of vancomycin and teicoplanin, but not those of clindamycin (CL), rifampin (RI) or cefazolin (CE). The extract also interfered with the synergism between vancomycin and gentamicin, that is, prevented them from 'working together' to maximize the antibacterial effect. The role of these slime polysaccharides in the control of foreign body infections and their interference in antimicrobial activities require further elucidation. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Infectious Diseases
Subject: Health
ISSN: 0022-1899
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: The risk of Pneumocystis carinii pneumonia among men infected with human immunodeficiency virus type I. Survival from early, intermediate, and late stages of HIV infection
- Abstracts: A Phase I evaluation of the safety and immunogenicity of vaccination with recombinant gp160 in patients with early human immunodeficiency virus infection
- Abstracts: Pneumocystis carinii pneumonia: the steroid dilemma. Steroids for Pneumocystis carinii pneumonia and respiratory failure in the acquired immunodeficiency syndrome: a reassessment