Utility of dapsone for prophylaxis of Pneumocystis carinii pneumonia in trimethoprim-sulfamethoxazole-intolerant, HIV-infected individuals

AIDS. 1993 Mar;7(3):355-9. doi: 10.1097/00002030-199303000-00008.

Abstract

Objective: To determine the safety and efficacy of 100 mg dapsone three times weekly for Pneumocystis carinii pneumonia (PCP) prophylaxis in HIV-infected, trimethoprim-sulfamethoxazole (TMP-SMX)-intolerant patients.

Design: Retrospective chart review of patients followed-up to 22 May 1992.

Setting: Infectious diseases outpatient clinic of a tertiary care center in suburban New York City.

Patients: Twenty-three HIV-infected patients requiring PCP prophylaxis with documented intolerance to TMP-SMX.

Main outcome measures: Patients were followed clinically and with laboratory testing at approximately monthly intervals.

Results: Dapsone was discontinued in nine (39%) patients because of adverse reactions. All reactions occurred within the first 2 months of treatment. Two (14%) of the remaining 14 patients developed histologically proven PCP over 126 patient-months of follow-up.

Conclusion: Approximately 40% of TMP-SMX-intolerant HIV-infected individuals are also intolerant of dapsone. Prophylaxis failures may be expected on a dose regimen of 100 mg dapsone three times weekly. More experience with other dose regimens and alternative agents is needed.

Publication types

  • Clinical Trial

MeSH terms

  • AIDS-Related Opportunistic Infections / microbiology
  • AIDS-Related Opportunistic Infections / prevention & control*
  • Adult
  • Contraindications
  • Dapsone / adverse effects
  • Dapsone / therapeutic use*
  • Drug Eruptions / etiology
  • Female
  • Fever / chemically induced
  • Glutathione / deficiency
  • HIV Infections / complications*
  • Humans
  • Leukopenia / chemically induced
  • Male
  • Pneumonia, Pneumocystis / complications
  • Pneumonia, Pneumocystis / prevention & control*
  • Retrospective Studies
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination

Substances

  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Dapsone
  • Glutathione