Vnitr Lek 1995, 41(10):688-691

[Successful prevention of Pneumocystis carinii infection with 1,920 mg of trimethoprim-sulfamethoxazole daily in patients with malignant hematopoietic diseases].

P Lemez, P Rysková, V Votava, M Suchmová, A Jirásek, I Rubík

Ustav hematologie a krevní transfuze, Praha.

During 1991-94 we treated 51 patients with acute myeloid leukaemias and 3 patients with a myelodysplastic syndrome of refractory anaemia with excess of blasts in transformation. The patients received trimethoprim-sulphamethoxazole (TMP-SMX) 1,920 mg daily as a prophylaxis of Pneumocystis carinii infections and selective decontamination of gastrointestinal tract. The majority of patients received TMP-SMX in their first course of chemotherapy with daunorubicin and cytosine arabinoside. Only one of the 18 patients without TMP-SMX prophylaxis during the first course of chemotherapy developed Pneumocystis carinii pneumonia. That pneumonia was successfully treated by intravenous administration of TMP-SMX 1920 mg four times a day. No other Pneumocystis carinii infection was encountered in all other patients during their clinical follow up or in autopsy material of expired patients. TMP-SMX prophylaxis had to be interrupted in 11 patients due to their suspicious allergic skin reactions, however, TMP-SMX was readministered in all without any skin changes attributable to TMP-SMX during next cycles of chemotherapy. TMP-SMX in a given daily dose of 1,920 mg seems to be a successful prophylaxis of Pneumocystis carinii infections in patients with malignant diseases of hematopoiesis.

Keywords: Acute Disease; Adult; Anemia, Refractory, with Excess of Blasts /immunology/; Humans; Immunocompromised Host; Leukemia, Myeloid /immunology/; Male; Opportunistic Infections /prevention & control/; Pneumonia, Pneumocystis /prevention & control/; Trimethoprim, Sulfamethoxazole Drug Combination /administration & dosage/

Published: October 1, 1995  Show citation