Summary
Trimethoprim-sulfamethoxazole (TMS) desensitization was carried out in three patients with AIDS and Pneumocystis carinii pneumonia (PCP) in whom treatment with TMS had to be discontinued after 8 to 12 days due to an allergic reaction. Although the pneumonia was under control we decided for a desensitization to TMS because of the frequent reinfection and the high mortality rate particularly if treatment is incomplete. On the first day the patients took 0.4 mg/2 mg trimethoprim/sulfamethoxazole orally. The dose was increased during 9 successive days to 80 mg/400 mg trimethoprim/sulfamethoxazole. From the 10th to the 16th day 160 mg/800 mg trimethoprim/sulfamethoxazole was given daily and subsequently twice daily which is the recommended dose for prophylaxis of PCP. The desensitization was successful in two patients and a PCP prophylaxis was possible.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- AIDS:
-
acquired immunodeficiency syndrome
- TMS:
-
trimethoprim-sulfamethoxazole
- PCP:
-
Pneumocystis carinii pneumonia
References
Allen JR, Curran JW (1985) Epidemiology of the acquired immunodeficiency syndrome. In: Gallin JI, Fauci AS (eds) Advances in host defence mechanisms, vol 5. Acquired immunodeficiency syndrome. Raven Press, New York, pp 1–17
Baumann WR, Jung RC, Koss M, Boylen CT, Navarro L, Sharma OP (1986) Incidence and mortality of adult respiratory distress syndrome: A prospective analysis from a large metropolitan hospital. Crit Care Med 14:1–4
Bell ET, Tapper ML, Pollock AA (1985) Sulphadiazine desensitization in AIDS patients. Lancet I:163
Fauci AS (1985) The acquired immunodeficiency syndrome: An update. Ann Intern Med 102:800–813
Fischl MA, Dickinson GM (1985) Trimethoprim-sulfamethoxazole prophylaxis of Pneumocystis carinii pneumonia in acquired immunodeficiency syndrome. Read before the 25th Interscience Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, 29 September to 2 October 1985
Gordin FM, Simon GL, Wofsy CB, Mills J (1984) Adverse reactions to trimethoprim-sulfamethoxazole in patients with the acquired immunodeficiency syndrome. Ann Intern Med 100:495–499
Gurney ME, Heinrich SP, Lee MR, Yin H-S (1986) Molecular cloning and expression of neuroleukin, a neurotrophic factor for spinal and sensory neurons. Science 234:566–574
Gurney ME, Apatoff BR, Spear GT, et al. (1986) Neuroleukin: a lymphokine product of lectin-stimulated T cells. Science 234:574–581
Haverkos HW (1984) Assessment of therapy for Pneumocystis carinii pneumonia. Am J Med 76:501–508
Holdsworth CD (1981) Sulphasalazine desensitization. Br Med J [Clin Res] 282:110–111
Hughes WT, McNabb PC, Makres TD, Feldman S (1974) Efficacy of trimethoprim and sulfamethoxazole in the prevention and treatment of Pneumocystis carinii pneumonia. Antimicrob Agents Chemother 5:289–293
Hughes WT, Feldman S, Sanyal SK (1975) Treatment of Pneumocystis carinii pneumonitis with trimethoprim-sulfamethoxazole. Can Med Assoc J 112:47–50
Hughes WT, Feldman S, Chaudhary SC, Ossi MJ, Cox F, Sanyal SK (1978) Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia. J Pediatr 92:285–291
Hughes TE, Almgren JD, McGuffin RW, Omoto RJ (1986) Co-trimoxazole desensitization in bone marrow transplantation. Ann Intern Med 105:148
Klemola E (1970) Hypersensitivity reactions to ampicillin in cytomegalovirus mononucleosis. Scand J Infect Dis 2:29–31
MacLean Smith R, Iwamoto GK, Richerson HB, Flaherty JP (1987) Trimethoprim-sulfamethoxazole desensitization in the acquired immunodeficiency syndrome. Ann Intern Med 106:335
Morris L, Distenfeld A, Amorosi E, Karpatkin S (1982) Autoimmune thrombocytopenic purpura in homosexual men. Ann Intern Med 96:714–717
Murray JF, Garay SM, Hopewell PC, Mills J, Snider GL, Stover DG (1987) NHLBI Workshop Summary: Pulmonary complications of the acquired immunodeficiency syndrome: An update. Am Rev Respir Dis 135:504–509
Pullen H, Wright N, Murdoch JM (1967) Hypersensitivity reactions to antibacterial drugs in infectious mononucleosis. Lancet II:1176–1178
Wachter RM, Luce JM, Turner J, Volberding P, Hopewell C (1986) Intensive care of patients with the acquired immunodeficiency syndrome: Outcome and changing patterns of utilization. Am Rev Respir Dis 134:891–896
Walsh CM, Nardi MA, Karpatkin S (1984) On the mechanism of thrombocytopenic purpura in sexually active homosexual men. N Engl J Med 311:635–639
Wharton M, Coleman DL, Fitz G, et al (1986) Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Ann Intern Med 105:37–44
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Papakonstantinou, G., Füeßl, H. & Hehlmann, R. Trimethoprim-sulfamethoxazole desensitization in AIDS. Klin Wochenschr 66, 351–353 (1988). https://doi.org/10.1007/BF01735793
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01735793