Comparison of dosages, intervals, and drugs in the prevention of Pneumocystis carinii pneumonia.
Comparison of dosages, intervals, and drugs in the prevention of Pneumocystis carinii pneumonia.
复制标题
预防卡氏肺孢子虫肺炎的剂量、间隔时间和药物比较。
DOI：
10.1128/aac.32.5.623
复制
发表时间：
1988
影响因子：
4.9
通讯作者：
Hughes,WT
中科院分区：
文献类型：
--
作者：
Hughes,WT
在皮质类固醇治疗的大鼠模型中，比较了甲氧苄啶（TMP）-磺胺甲恶唑（SMZ）、TMP-氨苯砜、氨苯砜和喷他脒预防卡氏肺孢子虫肺炎的效果。免疫抑制10周后，15只未治疗的对照动物中有11只（73%）出现卡氏肺孢子虫肺炎，而每天、每周、每两周或每月给予125 mg/kg氨苯砜的动物均无感染迹象。在免疫抑制开始后23天和50天给予单剂量氨苯砜的10只大鼠中，5只（50%）出现卡氏肺孢子虫肺炎。当每两周单次给药三种药物时，40%的TMP-SMZ治疗组大鼠发生卡氏肺孢子虫肺炎，而TMP-dapsone治疗组大鼠无一例发生卡氏肺孢子虫肺炎;尽管只有2例喷他脒治疗组大鼠存活，但均发生卡氏肺孢子虫肺炎。实验表明，氨苯砜是非常有效的化学预防卡氏肺孢子虫肺炎时，每月一次的间隔或更频繁，氨苯砜和TMP-氨苯砜是更有效的比TMP-SMZ时，每两周一次的间隔。似乎有理由预期，氨苯砜或TMP-氨苯砜每两周给药一次将为卡氏肺孢子虫肺炎高危患者提供有效且合理安全的化学预防方案，并且测试这种方案的研究是合理的。两周一次的剂量优于每月一次的剂量，以允许偶尔意外遗漏患者预期的剂量。
The efficacies of trimethoprim (TMP)-sulfamethoxazole (SMZ), TMP-dapsone, dapsone, and pentamidine were compared for the prevention of Pneumocystis carinii pneumonia in the corticosteroid-treated-rat model. While 11 (73%) of 15 untreated control animals had P. carinii pneumonia after 10 weeks of immunosuppression, none of the animals given 125 mg of dapsone per kg daily, weekly, biweekly, or monthly had evidence of infection. Of the 10 rats given a single dose of dapsone 23 and 50 days after immunosuppression was started, 5 (50%) had P. carinii pneumonia. When three drugs were given separately to groups of 10 rats in single doses biweekly, P. carinii pneumonia occurred in 40% of those treated with TMP-SMZ and in none of those treated with TMP-dapsone; although only 2 of those treated with pentamidine survived for evaluation, both had P. carinii pneumonia. The experiments showed that dapsone is highly effective in chemoprophylaxis for P. carinii pneumonia when given at monthly intervals or more frequently and that dapsone and TMP-dapsone are more effective than is TMP-SMZ when given at biweekly intervals. It seems reasonable to expect that biweekly doses of dapsone or TMP-dapsone would provide an effective and reasonably safe chemoprophylaxis regimen for patients at high risk for P. carinii pneumonia, and studies to test such a scheme are justifiable. Biweekly doses are preferred over monthly doses to allow for occasional inadvertent omission of doses expected from patients.