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[Adverse reactions to trimethoprim-sulfamethoxazole in AIDS patients]
B Irazábal1, E Camino, C Cid de Rivera
1Servicio de Alergia, Hospital de Cruces, Bilboa, Vizcaya.
Background:
The aim of the present was to evaluate the incidence of side effects to Trimethoprim-sulphamethoxazole (TMP-SMX) in 32 patients with AIDS and pneumonia by Pneumocystis carinii.
Methods:
A retrospective study was carried out following a protocol which included all items related with the drug used.
Results:
Side effects to TMP-SMX were seen in 75% of the patients treated with the most important and severe being at a cutaneous level. These severe reactions require withdrawal of the drug and its substitution by pentamidine in half of the cases, while in the remaining 25% the reactions were mild. To date none of the 9 patients prophylactically treated with TMP-SMX have relapsed over 3 years of follow up while 4 out of the 9 treated with pentamidine have had relapsed.
Conclusions:
Trimethoprim-sulphamethoxazole is the ideal prophylactic drug for those who are able to tolerate it. Following review of the literature 2 schedules of tolerance induction were proposed for use in patients who have had previous reactions with this drug, including a rapid schedule and another slow schedule.
Insights
Trimethoprim-sulphamethoxazole (TMP-SMX) caused side effects in 75% of AIDS patients with Pneumocystis pneumonia, often skin-related. However, TMP-SMX proved superior for prophylaxis, with no relapses compared to pentamidine.
Area of Science:
- Infectious Diseases
- Pharmacology
- Immunology