PMID- 33722465
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20210624
IS  - 1437-7780 (Electronic)
IS  - 1341-321X (Linking)
VI  - 27
IP  - 6
DP  - 2021 Jun
TI  - Primaquine plus clindamycin as a promising salvage therapy for Pneumocystis 
      jirovecii pneumonia: A retrospective analysis in Japanese patients.
PG  - 924-928
LID - S1341-321X(21)00070-2 [pii]
LID - 10.1016/j.jiac.2021.03.001 [doi]
AB  - Treatment of intractable Pneumocystis jirovecii pneumonia (PCP) patients with 
      primaquine (PQ) in combination with clindamycin (CLDM) was conducted by the 
      Research Group on Chemotherapy of Tropical Diseases (RG-CTD), as a kind of 
      compassionate use. Primaquine was not nationally licensed at the time but 
      imported by RG-CTD for the use in a clinical research to investigate safety and 
      efficacy in malaria treatment. Eighteen Japanese adult patients thus treated were 
      analyzed. Prior to the treatment with PQ-CLDM, most of the patients had been 
      treated with trimethoprim-sulfamethoxazole first, all of which being followed by 
      pentamidine and/or atovaquone treatment. This combination regimen of PQ-CLDM was 
      effective in 16 (89%) patients and developed adverse events (AEs) in five (28%) 
      patients. AEs included skin lesions, methemoglobinemia, and hepatic dysfunction, 
      though none of them were serious. As a second-line or salvage treatment for PCP, 
      PQ-CLDM appears to be a better option than pentamidine or atovaquone. Currently 
      in Japan, both PQ and CLDM are licensed drugs but neither of them is approved for 
      treatment of PCP. Considering the potentially fatal nature of PCP, approval of 
      PQ-CLDM for treating this illness should be urged.
CI  - Copyright (c) 2021 Japanese Society of Chemotherapy and The Japanese Association 
      for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
FAU - Koga, Michiko
AU  - Koga M
AD  - Advanced Clinical Research Center, Institute of Medical Science, University of 
      Tokyo, Tokyo, Japan.
FAU - Suganuma, Akihiko
AU  - Suganuma A
AD  - Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious 
      Diseases Center Komagome Hospital, Tokyo, Japan.
FAU - Kikuchi, Tadashi
AU  - Kikuchi T
AD  - Advanced Clinical Research Center, Institute of Medical Science, University of 
      Tokyo, Tokyo, Japan.
FAU - Yoshimura, Yukihiro
AU  - Yoshimura Y
AD  - Department of Infectious Diseases, Yokohama Municipal Citizen's Hospital, 
      Yokohama, Japan.
FAU - Shoji, Kensuke
AU  - Shoji K
AD  - Division of Infectious Diseases, National Center for Child Health and 
      Development, Tokyo, Japan.
FAU - Kobayashi, Ichiro
AU  - Kobayashi I
AD  - Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
FAU - Takezaki, Shunichiro
AU  - Takezaki S
AD  - Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
FAU - Kato, Yasuyuki
AU  - Kato Y
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine, Tokyo, Japan.
FAU - Kimura, Mikio
AU  - Kimura M
AD  - Department of Internal Medicine, Shin-Yamanote Hospital, Japan Anti-Tuberculosis 
      Association, Tokyo, Japan.
FAU - Maruyama, Haruhiko
AU  - Maruyama H
AD  - Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, 
      University of Miyazaki, Miyazaki, Japan. Electronic address: 
      hikomaru@med.miyazaki-u.ac.jp.
CN  - Research Group on Chemotherapy of Tropical Diseases, Japan
LA  - eng
PT  - Journal Article
DEP - 20210313
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
RN  - 3U02EL437C (Clindamycin)
RN  - MVR3634GX1 (Primaquine)
SB  - IM
MH  - Adult
MH  - Clindamycin/adverse effects
MH  - Humans
MH  - Japan
MH  - *Pneumocystis carinii
MH  - *Pneumonia, Pneumocystis/drug therapy
MH  - Primaquine/adverse effects
MH  - Retrospective Studies
MH  - Salvage Therapy
OTO - NOTNLM
OT  - Effectiveness
OT  - Pneumocystis pneumonia
OT  - Primaquine-clindamycin
OT  - Salvage therapy
OT  - Tolerability
COIS- Declaration of competing interest All authors have no conflict of interest to 
      declare.
EDAT- 2021/03/17 06:00
MHDA- 2021/06/25 06:00
CRDT- 2021/03/16 06:03
PHST- 2021/01/04 00:00 [received]
PHST- 2021/02/23 00:00 [revised]
PHST- 2021/03/01 00:00 [accepted]
PHST- 2021/03/17 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
PHST- 2021/03/16 06:03 [entrez]
AID - S1341-321X(21)00070-2 [pii]
AID - 10.1016/j.jiac.2021.03.001 [doi]
PST - ppublish
SO  - J Infect Chemother. 2021 Jun;27(6):924-928. doi: 10.1016/j.jiac.2021.03.001. Epub 
      2021 Mar 13.