PMID- 32820678
OWN - NLM
STAT- MEDLINE
DCOM- 20210610
LR  - 20220422
IS  - 1439-7609 (Electronic)
IS  - 1439-7595 (Linking)
VI  - 31
IP  - 3
DP  - 2021 May
TI  - The efficacy and safety of reduced-dose sulfamethoxazole-trimethoprim for 
      chemoprophylaxis of Pneumocystis pneumonia in patients with rheumatic diseases.
PG  - 629-635
LID - 10.1080/14397595.2020.1812834 [doi]
AB  - OBJECTIVES: Pneumocystis pneumonia (PCP) is a life-threatening opportunistic 
      infection. Sulfamethoxazole-trimethoprim (SMX/TMP) is the first-line drug for PCP 
      prophylaxis. However, adverse events (AEs) force clinicians to alter or reduce 
      the drug dosage. METHODS: We retrospectively reviewed all patients with rheumatic 
      diseases who received SMX/TMP for prophylaxis and glucocorticoid therapy between 
      April 2004 and March 2018. The rates of AEs, SMX/TMP discontinuation, and 
      incidence of PCP were analyzed. Patients were divided into the conventional group 
      and the dose-reduction group. RESULTS: One hundred forty-five patients and 75 
      patients were included in the conventional group and the dose-reduction group, 
      respectively. Compared to the dose-reduction group, the conventional group had a 
      significantly high frequency of AEs (10.7% vs. 24.1%; p = .017); however, the 
      rate of discontinuing SMX/TMP was not significantly different (8.0% vs. 14.5%; 
      p = .165). Thirteen conventional group patients required a reduced SMX/TMP dose 
      because of AEs; no patient developed PCP. The conventional SMX/TMP dose and renal 
      dysfunction were associated with AEs in multivariate analysis. CONCLUSION: 
      Patients who received a reduced SMX/TMP dose did not have PCP and had a lower 
      frequency of AEs. A reduction in SMX/TMP for PCP prophylaxis is effective and 
      safe in patients with rheumatic disease.
FAU - Harada, Tomoya
AU  - Harada T
AUID- ORCID: 0000-0002-6820-4814
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Kato, Ryohei
AU  - Kato R
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Sueda, Yuriko
AU  - Sueda Y
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Funaki, Yoshihiro
AU  - Funaki Y
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Takata, Miki
AU  - Takata M
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Okazaki, Ryota
AU  - Okazaki R
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
FAU - Hasegawa, Yasuyuki
AU  - Hasegawa Y
AD  - Division of Rheumatology, Tottori Prefectural Central Hospital, Tottori, Japan.
FAU - Yamasaki, Akira
AU  - Yamasaki A
AD  - Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori 
      University, Tottori, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200909
PL  - England
TA  - Mod Rheumatol
JT  - Modern rheumatology
JID - 100959226
RN  - 0 (Anti-Bacterial Agents)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Chemoprevention/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Pneumocystis/complications/drug therapy/*prevention & control
MH  - Retrospective Studies
MH  - Rheumatic Diseases/*complications
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage/adverse 
      effects/*therapeutic use
OTO - NOTNLM
OT  - Dose reduction
OT  - efficacy
OT  - pneumocystis pneumonia
OT  - prophylaxis
OT  - sulfamethoxazole-trimethoprim
EDAT- 2020/08/22 06:00
MHDA- 2021/06/11 06:00
CRDT- 2020/08/22 06:00
PHST- 2020/08/22 06:00 [pubmed]
PHST- 2021/06/11 06:00 [medline]
PHST- 2020/08/22 06:00 [entrez]
AID - 10.1080/14397595.2020.1812834 [doi]
PST - ppublish
SO  - Mod Rheumatol. 2021 May;31(3):629-635. doi: 10.1080/14397595.2020.1812834. Epub 
      2020 Sep 9.