Sutter Medical Center, Sacramento, CA, USA.
Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, CA, USA.
J Oncol Pharm Pract. 2021 Dec;27(8):1936-1939. doi: 10.1177/1078155220979046. Epub 2020 Dec 13.
Current recommendations for prophylaxis of pneumonia in oncology patients include administration of trimethoprim/sulfamethoxazole (TMP/SMX) three times weekly or the same total weekly dose given daily. The primary objective of this study was to evaluate the efficacy of two consecutive days per week of TMP/SMX for prevention of pneumonia (PJP) in pediatric oncology patients. A retrospective cohort, single-center analysis was conducted in oncology patients 21 years and younger who received TMP/SMX for PJP prophylaxis between February 1, 2013 and July 31, 2017. Changes to the prophylaxis regimen were documented and analyzed. A total of 322 patients received TMP/SMX on two consecutive days per week for PJP prevention, of whom four had confirmed PJP (1.3%). Neutropenia was the most common reason for switching to alternative prophylaxis therapy (11.5%). Two consecutive prophylaxis days with TMP/SMX may be insufficient to prevent PJP in children with hematologic malignancies. Neutropenia remains a barrier for TMP/SMX use for PJP prophylaxis. Further studies to compare PJP incidence in children receiving alternative prophylaxis regimens should be considered.
目前，肿瘤患者肺炎预防的建议包括每周三次使用甲氧苄啶/磺胺甲恶唑（TMP/SMX）或每天给予相同的总周剂量。本研究的主要目的是评估每周连续两天使用 TMP/SMX 预防儿科肿瘤患者肺炎（PJP）的疗效。对 2013 年 2 月 1 日至 2017 年 7 月 31 日期间接受 TMP/SMX 用于 PJP 预防的 21 岁及以下肿瘤患者进行了回顾性队列、单中心分析。记录并分析了预防方案的改变。共有 322 名患者接受了每周连续两天的 TMP/SMX 用于 PJP 预防，其中 4 名患者被确诊为 PJP（1.3%）。中性粒细胞减少症是转换为替代预防治疗的最常见原因（11.5%）。对于血液恶性肿瘤患儿，TMP/SMX 连续两天的预防可能不足以预防 PJP。中性粒细胞减少症仍然是 TMP/SMX 用于 PJP 预防的障碍。应考虑进一步研究比较接受替代预防方案的儿童的 PJP 发生率。
