Warnock A C, Rimland D
Department of Pharmacy Practice, Mercer University Southern School of Pharmacy, Atlanta, Georgia 30341, USA.
Pharmacotherapy. 1996 Nov-Dec;16(6):1030-8.
To compare the incidence of Pneumocystis carinii pneumonia (PCP) in patients infected with the human immunodeficiency virus (HIV) receiving one of three prophylactic agents.
Retrospective chart review.
A university-affiliated Department of Veterans' Affairs medical center HIV clinic.
All 200 HIV-infected patients enrolled in the clinic who were prescribed a PCP prophylactic drug during 18 months.
Patients were administered oral trimethoprim-sulfamethoxazole (TMP-SMX) DS, oral dapsone, or aerosolized pentamidine in a heirarchic fashion. A subset of 110 patients received only one of the prophylaxis regimens for at least 6 months; they were examined separately for the purpose of statistical analysis.
One case of PCP was diagnosed in 1110 patient-months of oral TMP-SMX DS therapy, 6 in 418 patient-months of oral dapsone therapy, and 3 in 164 patient-months of aerosolized pentamidine therapy. In the subset population, the documented incidence of PCP was 0% among 71 TMP-SMX DS-treated patients, 16% among 25 dapsone-treated patients (p < 0.004), and 14% among 14 aerosolized pentamidine-treated patients (p < 0.03). For patients receiving primary prophylaxis, the incidence of PCP was 0% for 58 receiving TMP-SMX, 15% for 20 receiving dapsone (p = 0.015), and 17% for 6 receiving pentamidine (p = 0.094).
We believe TMP-SMX DS was more effective than oral dapsone or aerosolized pentamidine in preventing PCP in these HIV-infected patients.
比较接受三种预防药物之一的人类免疫缺陷病毒（HIV）感染患者中卡氏肺孢子虫肺炎（PCP）的发病率。
回顾性病历审查。
一所大学附属的退伍军人事务部医疗中心的HIV诊所。
该诊所登记的所有200名HIV感染患者，他们在18个月内被开具了PCP预防药物。
患者按分层方式接受口服甲氧苄啶-磺胺甲恶唑（TMP-SMX）双倍剂量、口服氨苯砜或雾化喷他脒治疗。110名患者的一个亚组至少6个月仅接受一种预防方案治疗；为进行统计分析，对他们进行单独检查。
在1110个口服TMP-SMX双倍剂量治疗的患者月中诊断出1例PCP；在418个口服氨苯砜治疗的患者月中有6例；在164个雾化喷他脒治疗的患者月中有3例。在亚组人群中，71名接受TMP-SMX双倍剂量治疗的患者中PCP的记录发病率为0%，25名接受氨苯砜治疗的患者中为16%（p<0.004），14名接受雾化喷他脒治疗的患者中为14%（p<0.03）。对于接受初级预防的患者，58名接受TMP-SMX治疗的患者中PCP发病率为0%，20名接受氨苯砜治疗的患者中为15%（p=0.015），6名接受喷他脒治疗 的患者中为17%（p=0.094）。
我们认为在预防这些HIV感染患者的PCP方面，TMP-SMX双倍剂量比口服氨苯砜或雾化喷他脒更有效。
