Irazábal B, Camino E, Cid de Rivera C, Aguirrebengoa K, Urkijo J C
Servicio de Alergia, Hospital de Cruces, Bilboa, Vizcaya.
Enferm Infecc Microbiol Clin. 1993 Oct;11(8):429-32.
The aim of the present was to evaluate the incidence of side effects to Trimethoprim-sulphamethoxazole (TMP-SMX) in 32 patients with AIDS and pneumonia by Pneumocystis carinii.
A retrospective study was carried out following a protocol which included all items related with the drug used.
Side effects to TMP-SMX were seen in 75% of the patients treated with the most important and severe being at a cutaneous level. These severe reactions require withdrawal of the drug and its substitution by pentamidine in half of the cases, while in the remaining 25% the reactions were mild. To date none of the 9 patients prophylactically treated with TMP-SMX have relapsed over 3 years of follow up while 4 out of the 9 treated with pentamidine have had relapsed.
Trimethoprim-sulphamethoxazole is the ideal prophylactic drug for those who are able to tolerate it. Following review of the literature 2 schedules of tolerance induction were proposed for use in patients who have had previous reactions with this drug, including a rapid schedule and another slow schedule.