Effectiveness and safety of lower dose sulfamethoxazole/trimethoprim therapy for Pneumocystis jirovecii pneumonia in patients with systemic rheumatic diseases: A retrospective multicenter study
Effectiveness and safety of lower dose sulfamethoxazole/trimethoprim therapy for Pneumocystis jirovecii pneumonia in patients with systemic rheumatic diseases: A retrospective multicenter study
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DOI：
10.1016/j.jiac.2018.11.014
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发表时间：
2019-04-01
影响因子：
2.2
通讯作者：
Niimi, Akio
中科院分区：
文献类型：
--
作者：
Ohmura, Shin-ichiro;Naniwa, Taio;Niimi, Akio
目的：评价小剂量磺胺甲恶唑/甲氧苄啶(SMX/TMP)治疗系统性风湿性疾病患者日本肺孢子虫肺炎(PCP)的有效性和安全性。方法：在这项多中心的回顾性研究中，我们比较了SMX/TMP治疗PCP的有效性和安全性，按SMX/TMP的初始剂量：低剂量，按照不良事件通用术语标准，=3。按肺泡-动脉血氧梯度定义的严重低氧血症分层时，三组患者的30天存活率和治疗改革率相似，但严重不良反应的发生率在低剂量组显著减少。低剂量组与14天内的治疗修改和严重的不良反应呈独立的负相关。
Objectives: To evaluate the effectiveness and safety of lower-dose sulfamethoxazole/trimethoprim therapy (SMX/TMP) for Pneumocystis jirovecii pneumonia (PCP) in patients with systemic rheumatic diseases.Methods: In this multicenter retrospective study, we compared effectiveness and safety of SMX/TMP for the treatment of PCP among patients divided into three groups according to the initial dosage of SMX/TMP: the low, = 3 according to the Common Terminology Criteria for Adverse Events. When stratified by presence of severe hypoxemia defined by alveolar-arterial O2 gradient >= 45 mmHg, the 30-day survival and treatment modification rate were similar among the three groups, but frequency of severe ADRs were significantly decreased in the low-dose group. The low-dose group was independently and negatively associated with treatment modification within 14 days and severe ADRs.Conclusions: Lower dose SMX/TMP therapy with