Prevention of pneumocystis pneumonia. Use of continuous sulfamethoxazole-trimethroprim therapy
R. E. Harris, J. A. McCallister, S. A. Allen, A. S. Barton and R. L. Baehner
Owing to a 15% attack rate of Pneumocystis carinii pneumonitis (PCP) among
the leukemic population of Riley Hospital, Indianapolis, a two-year study
using continuous low-dosage sulfamethoxazole-trimethoprim to prevent PCP
was started in January 1977. A total of 229 pediatric cancer patients
considered at high risk for getting PCP received prophylaxis, while 19
additonal low-risk cancer patients did not receive
sulfamethoxazole-trimethoprim. None of these 248 patients contracted PCP.
However, five cases of PCP did occur among ten additional high-risk
patients who failed to receive this preparation for a variety of reasons.
Complications of the continuous prophylaxis program included neutropenia,
rash, and gastrointestinal complaints. This study confirms that continuous,
low-dosage sulfamethoxazole-trimethoprim prophylaxis is effective in
preventing PCP in susceptible immunosuppressed patients but is ineffective
in eradicating the organism from the population at risk.
