Wilber R B, Feldman S, Malone W J, Ryan M, Aur R J, Hughes W T
Am J Dis Child. 1980 Jul;134(7):643-8. doi: 10.1001/archpedi.1980.02130190011004.
Sulfamethoxazole-trimethoprim was administered prophylactically to 786 patients judged to be at sufficient risk for development of Pneumocystis carinii pneumonitis. The selection of patients, administration of the agents, and surveillance for compliance were the responsibility of the attending oncologists rather than specialists in infectious diseases, as in an earlier trial at this center. The recommended dosage was trimethoprim, 150 mg/sq m/day, and sulfamethoxazole, 750 mg/sq m/day. Over a three-year study period, nine cases of P carinii pneumonitis occurred at this institution, with none attributable to drug failure. Adverse reactions, skin rashes mainly, were noted in 43 patients, and one patient died with Stevens-Johnson syndrome. These results confirm the efficacy of sulfamethoxazole-trimethoprim in preventing P carinii pneumonitis in childhood cancer patients and illustrate the feasibility of large-scale unstructured delivery of the combination to patients with malignant diseases frequently associated with this pneumonia.
对786名被判定有足够风险发生卡氏肺孢子虫肺炎的患者进行了磺胺甲恶唑-甲氧苄啶预防性给药。与该中心早期的一项试验不同，患者的选择、药物的给药以及依从性监测由主治肿瘤学家负责，而非传染病专家。推荐剂量为甲氧苄啶150mg/平方米/天，磺胺甲恶唑750mg/平方米/天。在为期三年的研究期间，该机构发生了9例卡氏肺孢子虫肺炎病例，无一例归因于药物失效。43名患者出现了不良反应，主要是皮疹，1名患者死于史蒂文斯-约翰逊综合征。这些结果证实了磺胺甲恶唑-甲氧苄啶在预防儿童癌症患者卡氏肺孢子虫肺炎方面的疗效，并说明了将该联合用药大规模无组织地提供给经常伴有这种肺炎的恶性疾病患者的可行性。
