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High-dose therapy with the combination drug trimethoprim-sulfamethoxazole for the treatment of patients with Pneumocystis carinii pneumonia (PCP) is usually contraindicated in trimethoprim-sulfamethoxazole–intolerant patients with acquired immunodeficiency syndrome (AIDS). However, clinicians may have to reintroduce trimethoprim-sulfamethoxazole at high dosages to treat these patients with PCP. In those circumstances, prescribing drugs such as corticosteroids, which will decrease the risk of adverse cutaneous reaction, is desirable. Corticosteroids significantly reduced the incidence of adverse reaction to trimethoprim-sulfamethoxazole during treatment of patients with AIDS-associated PCP in 4 studies.^1-4

We followed up 6 trimethoprim-sulfamethoxazole–intolerant patients with AIDS-associated PCP in whom high-dose trimethoprim-sulfamethoxazole was readministered together with corticosteroids.

Patients and Methods.

We retrospectively studied 6 consecutive cases of PCP in trimethoprim-sulfamethoxazole–intolerant patients treated with a combination of corticosteroids) and trimethoprim-sulfamethoxazole.

A dose of 960 mg of trimethoprim and 4800 mg of sulfamethoxazole was administered daily (in 3 oral doses or 4 infusions) for 21 days. Patients were treated with corticosteroids . . . [Full Text of this Article]

Results.

Comment.


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