Gordin F M, Simon G L, Wofsy C B, Mills J
Ann Intern Med. 1984 Apr;100(4):495-9. doi: 10.7326/0003-4819-100-4-495.
We reviewed the charts of 38 patients with the acquired immunodeficiency syndrome who were treated for Pneumocystis carinii pneumonia. Only 5 of 37 patients started on trimethoprim-sulfamethoxazole were able to complete treatment; in 29 patients drug toxicity occurred and in 19 treatment was changed due to adverse reactions that included rash, fever, neutropenia, thrombocytopenia, and transaminase elevation. Pentamidine was given to 30 patients (1 as initial treatment); toxicity occurred in 13 but only 4 required a change in drug. Adverse reactions from pentamidine included fever, rash, neutropenia, transaminase elevation, azotemia, and hypoglycemia. Patients received trimethoprim-sulfamethoxazole a median of 9.5 days, and pentamidine, a median of 12.5 days. Toxicity from trimethoprim-sulfamethoxazole appeared earlier than toxicity associated with pentamidine (7.5 versus 9.5 days of treatment). In patients with the acquired immunodeficiency syndrome, trimethoprim-sulfamethoxazole has a higher incidence of adverse reactions than pentamidine (p less than 0.005).
我们回顾了38例因卡氏肺孢子虫肺炎接受治疗的获得性免疫缺陷综合征患者的病历。在37例开始使用甲氧苄啶-磺胺甲恶唑治疗的患者中，只有5例能够完成治疗；29例出现药物毒性，19例因不良反应（包括皮疹、发热、中性粒细胞减少、血小板减少和转氨酶升高）而更换治疗药物。30例患者接受了喷他脒治疗（1例作为初始治疗）；13例出现毒性，但只有4例需要更换药物。喷他脒的不良反应包括发热、皮疹、中性粒细胞减少、转氨酶升高、氮质血症和低血糖。患者接受甲氧苄啶-磺胺甲恶唑治疗的中位时间为9.5天，接受喷他脒治疗的中位时间为12.5天。甲氧苄啶-磺胺甲恶唑的毒性比喷他脒出现得更早（治疗7.5天与9.5天）。在获得性免疫缺陷综合征患者中，甲氧苄啶-磺胺甲恶唑的不良反应发生率高于喷他脒（p<0.005）。
