Okada J, Kadoya A, Rana M, Ishikawa A, Iikuni Y, Kondo H
Department of Internal Medicine, Kitasato University School of Medicine, Japan.
Kansenshogaku Zasshi. 1999 Nov;73(11):1123-9. doi: 10.11150/kansenshogakuzasshi1970.73.1123.
The efficacy and adverse effects of prophylactic administration of Sulfamethoxazole-Trimethoprim (ST) for Pneumocystis carinii Pneumonia (PCP) were assessed in patients with connective tissue diseases (CTD). Eighty-four patients who were receiving more than 40 mg/day of prednisolone were entried in the present study. Patients with at least one of the two PCP risk factors (interstitial pulmonary fibrosis and lymphopenia), were administered either one (11 patients) or two (26 patients) ST tablets/day. The remaining 47 patients who did not receive ST served as the controls. Although PCP was detected in 4.3% of the patients in the no-ST group, none of the patients who received ST developed PCP. Five of these 26 patients who received two tablets of ST/day, experienced adverse reactions. However, no adverse reactions were detected in the patients who received one tablet of ST/day (p < 0.05). Abnormal laboratory data were obtained for 10 (38.5%) of the patients who received two tablets of ST/day and for 4 (36.4%) of the 11 patients who received one tablet of ST/day. The results of the present study suggest that the prophylactic administration of one tablets of ST in patients with CTD that have at least one of the two PCP risk factors is effective in preventing PCP.
在结缔组织病（CTD）患者中评估了预防性服用复方磺胺甲恶唑（ST）治疗卡氏肺孢子虫肺炎（PCP）的疗效和不良反应。本研究纳入了84例接受泼尼松龙剂量超过40mg/天的患者。具有PCP两个危险因素（间质性肺纤维化和淋巴细胞减少）中至少一项的患者，每天服用1片（11例患者）或2片（26例患者）ST。其余47例未接受ST的患者作为对照。虽然未接受ST组中有4.3%的患者检测到PCP，但接受ST的患者中无一例发生PCP。这26例每天服用2片ST的患者中有5例出现不良反应。然而，每天服用1片ST的患者未检测到不良反应（p<0.05）。每天服用2片ST的患者中有10例（38.5%）以及每天服用1片ST的11例患者中有4例（36.4%）获得了异常实验室数据。本研究结果表明，在具有PCP两个危险因素中至少一项的CTD患者中预防性服用1片ST可有效预防PCP。
