Adverse Events Associated with Trimethoprim-Sulfamethoxazole and Atovaquone during the Treatment of AIDS-Related Pneumocystis carinii Pneumonia

• Published in: The Journal of infectious diseases Vol. 171; no. 5; pp. 1295 - 1301
• Main Authors: Hughes, Walter T., LaFon, Stephen W., Scott, Janna D., Masur, Henry
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-05-1995; University of Chicago Press
• Subjects: Adult; AIDS; AIDS-Related Opportunistic Infections - drug therapy; Anemia; Antifungal Agents - adverse effects; Antifungal Agents - blood; Antifungal Agents - pharmacokinetics; Atovaquone; Azotemia; Biological and medical sciences; Blood plasma; Dosage; Double-Blind Method; Drug toxicity and drugs side effects treatment; Exanthema; Female; Fever; Humans; Major Articles; Male; Medical sciences; Medications; Middle Aged; Miscellaneous (drug allergy, mutagens, teratogens...); Naphthoquinones - adverse effects; Naphthoquinones - blood; Naphthoquinones - pharmacokinetics; Pharmacology. Drug treatments; Pneumocystis pneumonia; Pneumonia; Pneumonia, Pneumocystis - drug therapy; Trimethoprim, Sulfamethoxazole Drug Combination - adverse effects; Trimethoprim, Sulfamethoxazole Drug Combination - blood; Trimethoprim, Sulfamethoxazole Drug Combination - pharmacokinetics; Sulfanilamide derivatives; Immunopathology; Lung disease; Protozoa; Drug combination; Pneumonia; Respiratory disease; Toxicity; Pneumocystis carinii; AIDS; Concentration; Immune deficiency; Incidence; Blood plasma; Infection; Antibiotic; Chemotherapy; Treatment; Viral disease; Sporozoa
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/171.5.1295

Atovaquone was compared to trimethoprim-sulfamethoxazole (TMP-SMZ) for the relationship of time receiving therapy, plasma drug concentrations, and incidence of adverse reactions in patients with AIDS-associated Pneumocystis carinii pneumonia. Treatment-limiting adverse events occurred in 9% of atovaquone-treated patients and 24% of TMP-SMZ-treated patients. Adverse events usually did not occur before day 7 for either treatment. Only the incidence of rash increased with increasing plasma concentrations of atovaquone. The incidence of anemia, neutropenia, and azotemia increased with increasing trimethoprim plasma concentration, while other adverse events (gastrointestinal disorders, rash, fever, and liver function abnormalities) were independent of plasma drug concentration.