PMID- 37797822
OWN - NLM
STAT- MEDLINE
DCOM- 20240122
LR  - 20240201
IS  - 1437-7780 (Electronic)
IS  - 1341-321X (Linking)
VI  - 30
IP  - 2
DP  - 2024 Feb
TI  - Sulfamethoxazole-trimethoprim for pneumocystis pneumonia prophylaxis, causes of 
      discontinuation and thrombocytopenia observed during administration: A 
      single-center retrospective study.
PG  - 141-146
LID - S1341-321X(23)00240-4 [pii]
LID - 10.1016/j.jiac.2023.09.030 [doi]
AB  - INTRODUCTION: The development of pneumocystis pneumonia (PCP) has recently become 
      a growing concern; thus, its prevention has become increasingly important. 
      Sulfamethoxazole-trimethoprim (ST) is a cost-effective first-line and 
      prophylactic treatment for PCP. However, ST administration criteria for PCP 
      prophylaxis remain unclear and are often discontinued because of adverse events 
      (AEs). In this study, we aimed to investigate the causes of ST discontinuation 
      and the associated AEs using objective data. METHODS: We retrospectively analyzed 
      the data of 162 patients admitted to Kansai Medical University Hospital between 
      January 2018 and December 2020, who received ST for PCP prophylaxis. We compared 
      clinical characteristics, laboratory data, and incidence of AEs between ST 
      non-discontinuation and ST discontinuation groups. Additionally, we divided the 
      patients into non-developing and developing thrombocytopenia (>/= Grade 1) groups 
      based on the investigation results. RESULTS: No patients developed PCP while 
      receiving ST. The most common causes of ST discontinuation were thrombocytopenia 
      (37%), liver dysfunction (20%), and rash (18%). Multivariate analysis revealed 
      thrombocytopenia (>/= Grade 1) as a factor significantly associated with ST 
      discontinuation. Furthermore, we identified three factors correlated with 
      thrombocytopenia (>/= Grade 1): age >/=50 years, lymphocyte count <1000/muL, and 
      platelet count <180,000/muL. CONCLUSIONS: Patients with the aforementioned factors 
      are at higher risk of developing thrombocytopenia (>/= Grade 1) during ST 
      administration for PCP prophylaxis. Therefore, platelet count monitoring is 
      essential to enhance safety and efficacy of ST treatment. Nonetheless, further 
      research is warranted to explore additional implications and interventions.
CI  - Copyright (c) 2023 Japanese Society of Chemotherapy, Japanese Association for 
      Infectious Diseases, and Japanese Society for Infection Prevention and Control. 
      Published by Elsevier Ltd. All rights reserved.
FAU - Hashimoto, Misaki
AU  - Hashimoto M
AD  - Department of Pharmacy, Kansai Medical University Hospital, Osaka, Japan. 
      Electronic address: ky051124519@gmail.com.
FAU - Hiraiwa, Miho
AU  - Hiraiwa M
AD  - Department of Pharmacy, Kansai Medical University Hospital, Osaka, Japan.
FAU - Uchitani, Kazuki
AU  - Uchitani K
AD  - Department of Pharmacy, Kansai Medical University Hospital, Osaka, Japan.
FAU - Ueda, Masahiro
AU  - Ueda M
AD  - Faculty of Pharmaceutical Sciences, Setsunan University, Osaka, Japan.
FAU - Tanaka, Masayuki
AU  - Tanaka M
AD  - Faculty of Pharmaceutical Sciences, Setsunan University, Osaka, Japan.
FAU - Nishiyama, Norito
AU  - Nishiyama N
AD  - Department of Pharmacy, Kansai Medical University Hospital, Osaka, Japan; 
      Department of Infection Control, Kansai Medical University Hospital, Osaka, 
      Japan.
FAU - Miyashita, Naoyuki
AU  - Miyashita N
AD  - Department of Infection Control, Kansai Medical University Hospital, Osaka, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20231004
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Retrospective Studies
MH  - *Pneumonia, Pneumocystis/epidemiology/prevention & control/drug therapy
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects
MH  - *Thrombocytopenia/drug therapy
OTO - NOTNLM
OT  - Adverse event
OT  - Pneumocystis pneumonia
OT  - Sulfamethoxazole-trimethoprim
OT  - Thrombocytopenia
COIS- Declaration of competing interest None.
EDAT- 2023/10/06 00:43
MHDA- 2024/01/22 06:42
CRDT- 2023/10/05 19:33
PHST- 2023/07/03 00:00 [received]
PHST- 2023/09/26 00:00 [revised]
PHST- 2023/09/30 00:00 [accepted]
PHST- 2024/01/22 06:42 [medline]
PHST- 2023/10/06 00:43 [pubmed]
PHST- 2023/10/05 19:33 [entrez]
AID - S1341-321X(23)00240-4 [pii]
AID - 10.1016/j.jiac.2023.09.030 [doi]
PST - ppublish
SO  - J Infect Chemother. 2024 Feb;30(2):141-146. doi: 10.1016/j.jiac.2023.09.030. Epub 
      2023 Oct 4.