Dapsone-trimethoprim for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome

Ann Intern Med. 1986 Jul;105(1):45-8. doi: 10.7326/0003-4819-105-1-45.

Abstract

All patients with the acquired immunodeficiency syndrome and a first episode of Pneumocystis carinii pneumonia seen at the San Francisco General Hospital between November 1984 and April 1985 were evaluated for oral treatment with dapsone (100 mg/d) plus trimethoprim (20 mg/kg body weight X d). All 15 patients who met the entry criteria improved clinically and radiographically within 3 to 10 days after starting treatment. Repeat pulmonary function tests and gallium lung scans after 3 weeks of therapy also showed improvement. Although side effects occurred in 14 patients, in only 2 were they severe enough to require stopping therapy. Both of these patients had worsening skin rash, and dapsone-trimethoprim therapy was stopped after 10 days. When compared with trimethoprim-sulfamethoxazole or pentamidine used to treat P. carinii pneumonia in similar patients, oral dapsone-trimethoprim is at least as effective, seems to be better tolerated, and may have a lower frequency of serious side effects.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Bronchoscopy
  • Dapsone / administration & dosage
  • Dapsone / adverse effects
  • Dapsone / therapeutic use*
  • Drug Eruptions / etiology
  • Drug Therapy, Combination
  • Fever / therapy
  • Hematocrit
  • Humans
  • Liver / enzymology
  • Nausea / chemically induced
  • Pneumonia, Pneumocystis / drug therapy*
  • Pneumonia, Pneumocystis / etiology
  • Respiratory Function Tests
  • Sputum / parasitology
  • Trimethoprim / administration & dosage
  • Trimethoprim / adverse effects
  • Trimethoprim / therapeutic use*

Substances

  • Dapsone
  • Trimethoprim