Atovaquone Compared with Dapsone for the Prevention of Pneumocystis carinii Pneumonia in Patients with HIV Infection Who Cannot Tolerate Trimethoprim, Sulfonamides, or Both

• Published in: The New England journal of medicine Vol. 339; no. 26; pp. 1889 - 1895
• Main Authors: El-Sadr, Wafaa M, Murphy, Robert L, Yurik, Teresa McCabe, Luskin-Hawk, Roberta, Cheung, Tony W, Balfour, Henry H, Eng, Robert, Hooton, Thomas M, Kerkering, Thomas M, Schutz, Malte, van der Horst, Charles, Hafner, Richard
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 24-12-1998
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiparasitic agents; Biological and medical sciences; HIV; Human immunodeficiency virus; Medical sciences; Mortality; Pharmacology. Drug treatments; Pneumocystis carinii; Pneumonia; Human; Immunopathology; Prognosis; Atovaquone; Sulfone; Dapsone; Pneumocystis carinii; AIDS; Immune deficiency; Fungi; Infection; Chemotherapy; Treatment; Follow up study; Viral disease; Parasiticid; Complication; Fungi Imperfecti; Comparative study; Thallophyta
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199812243392604

The prevention of
Pneumocystis carinii
pneumonia has had a substantial influence on the course of human immunodeficiency virus (HIV) disease.
1
,
2
Although trimethoprim–sulfamethoxazole is the treatment of choice for prophylaxis against
P. carinii
pneumonia, intolerance often limits its use and makes it necessary to use alternative regimens.
3
Dapsone, alone or in combination with pyrimethamine, is a commonly recommended prophylactic regimen for
P. carinii
pneumonia in patients who cannot tolerate trimethoprim–sulfamethoxazole.
4
Dapsone plus pyrimethamine has been shown to be superior to aerosolized pentamidine for the prevention of toxoplasmosis.
5
However, dapsone has limitations: it is less effective than trimethoprim–sulfamethoxazole for the prevention . . .