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Treatment with redu...
Treatment with reduced dose trimethoprim-sulfamethoxazole is effective in mild to moderate Pneumocystis jirovecii pneumonia in patients with hematologic malignancies
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- Hammarström, Helena (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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- Krifors, Anders (author)
- Uppsala universitet,Karolinska Institutet,Centrum för klinisk forskning, Västerås,Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden.
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- Athlin, Simon, 1971- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Infectious Diseases,Örebro Univ, Fac Med & Hlth, Dept Infect Dis, Örebro, Sweden.
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- Friman, Vanda, 1952 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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- Golestani, Karan (author)
- Department of Infectious Diseases, Skåne University Hospital, Malmö, Sweden,Skane Univ Hosp, Dept Infect Dis, Malmö, Sweden.
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- Hällgren, Anita (author)
- Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Linköping Univ, Dept Infect Dis Ostergotland, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
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- Otto, Gisela (author)
- Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Infect Dis, Lund, Sweden.
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- Oweling, Sara (author)
- Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Linköping Univ, Dept Infect Dis Ostergotland, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
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- Pauksen, Karlis (author)
- Uppsala universitet,Infektionsmedicin
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- Kinch, Amelie, 1973- (author)
- Uppsala universitet,Infektionsmedicin
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- Blennow, Ola (author)
- Karolinska Institutet,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Dept Med Huddinge, Unit Infect Dis, Stockholm, Sweden.
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(creator_code:org_t)
- 2022-05-20
- 2023
- English.
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In: Clinical Infectious Diseases. - : University of Chicago Press. - 1058-4838 .- 1537-6591. ; 76:3, s. e1252-e1260
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Abstract
Subject headings
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- BACKGROUND: Recent studies have reported that reduced dose trimethoprim-sulfamethoxazole (TMP-SMX) may be effective in the treatment of Pneumocystis jirovecii pneumonia (PJP) but data is lacking for patients with hematologic malignancies.METHODS: This retrospective study included all adult hematologic patients with PJP between 2013 and 2017 at six Swedish University Hospitals. Treatment with 7.5-15 mg TMP/kg/day (reduced dose) was compared with >15-20 mg TMP/kg/day (standard dose), after correction for renal function. The primary outcome was the change in respiratory function (ΔPaO2/FiO2) between baseline and day 8. Secondary outcomes were clinical failure and/or death at day 8 and death at day 30.RESULTS: Out of a total of 113 included patients, 80 patients received reduced dose, and 33 patients received standard dose. The overall 30-day mortality in the whole cohort was 14%. There were no clinically relevant differences in ΔPaO2/FiO2 at day 8 between the treatment groups, neither before nor after controlling for potential confounders in an adjusted regression model (-13,6 mmHg [95% CI -56,7-29,5] and -9,4 mmHg, [95% CI -50.5-31.7], respectively). Clinical failure and/or death at day 8 and 30-day mortality did not differ significantly between the groups, 18% vs. 21% and 14% vs. 15%, respectively. Among patients with mild to moderate pneumonia, defined as PaO2/FiO2>200 mmHg, all 44 patients receiving reduced dose were alive at day 30.CONCLUSION: In this cohort of 113 patients with hematologic malignancies, reduced dose TMP-SMX was effective and safe for treating mild to moderate PJP.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Pneumocystis pneumonia
- Hematologic malignancies
- Treatment Outcome
- trimethoprim-sulfamethoxazole
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hammarström, Hel ...
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Krifors, Anders
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Athlin, Simon, 1 ...
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Friman, Vanda, 1 ...
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Golestani, Karan
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Hällgren, Anita
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Otto, Gisela
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Oweling, Sara
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Pauksen, Karlis
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Kinch, Amelie, 1 ...
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Blennow, Ola
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Clinical Infecti ...
- By the university
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Örebro University
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Linköping University
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Karolinska Institutet
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Uppsala University
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University of Gothenburg