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首页> 外文期刊>Antimicrobial agents and chemotherapy. >A Four-Center Retrospective Study of the Efficacy and Toxicity of Low-Dose Trimethoprim-Sulfamethoxazole for the Treatment of Pneumocystis Pneumonia in Patients without HIV Infection
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A Four-Center Retrospective Study of the Efficacy and Toxicity of Low-Dose Trimethoprim-Sulfamethoxazole for the Treatment of Pneumocystis Pneumonia in Patients without HIV Infection

机译：一种四中心回顾性研究，低剂量三甲吡啶 - 磺胺甲氧唑治疗肺炎肺炎患者肺炎肺炎患者，无艾滋病毒感染

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The dose of trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of Pneumocystis pneumonia (PCP) in patients without human immunodeficiency virus (HIV) infection has not been verified. The aim of this study was to investigate the efficacy and toxicity of a low-dose TMP-SMX regimen in such patients. A retrospective study was conducted in four hospitals. We reviewed the medical records of patients with PCP but not HIV (non-HIV-PCP) who were treated with TMP-SMX between 2003 and 2016. The patients were divided into conventional-dose (TMP, 15 to 20 mg/kg/day) and low-dose (TMP, 20 mg/kg/day) treatment were excluded. Grouping was done according to a correction dose, which was based on renal function. Eighty-two patients had non-HIV-PCP. The numbers of patients who received high-, conventional-, and low-dose treatments were 5, 36, and 41, respectively. Kaplan-Meier analysis for death associated with PCP showed no statistically significant difference in survival rates between the conventional-and low-dose groups. Ninety-day cause-specific mortality rates were 25.0% and 19.5% in the conventional-dose and low-dose groups (P = 0.76), respectively. Adverse events that were graded as >= 3 according to the Common Terminology Criteria for Adverse Events (version 4.0) (National Cancer Institute, 2010) were 41.7% and 17.1% in the conventional-dose and low-dose groups (P = 0.02), respectively. Moreover, vomiting (P = 0.03) and a decrease in platelet count (P = 0.03) occurred more frequently in the conventional dose group. Treatment of non-HIV-PCP with low-dose or conventional-dose TMP-SMX produces comparable survival rates; however, the low-dose regimen is better tolerated and associated with fewer adverse effects.
机译：尚未验证用于治疗没有人体免疫缺陷病毒（HIV）感染的患者肺炎肺炎（PCP）治疗肺吡啶-磺胺嘧啶（TMP-SMX）的剂量。本研究的目的是探讨低剂量TMP-SMX方案在此类患者中的疗效和毒性。回顾性研究是在四家医院进行的。我们审查了PCP患者的病历，但未在2003年至2016年间在TMP-SMX治疗的HIV（非HIV-PCP）。患者分为常规剂量（TMP，15至20毫克/千克/天）和低剂量（TMP，20mg / kg /天）处理被排除在外。根据校正剂量进行分组，基于肾功能。八十二名患者有非HIV-PCP。接受高，常规和低剂量治疗的患者的数量分别为5,36和41。与PCP相关的死亡的Kaplan-Meier分析显示出常规和低剂量组之间的存活率没有统计学上显着差异。常规剂量和低剂量组（P = 0.76）分别为90天的原因特异性死亡率为25.0％和19.5％。根据常见术语（版本4.0）（National Cancer Institute，2010）的常见术语标准进行评级的不良事件是常规剂量和低剂量组的41.7％和17.1％（P = 0.02） ， 分别。此外，在常规剂量组中，呕吐（p = 0.03）和血小板计数的降低（p = 0.03）发生。用低剂量或常规剂量TMP-SMX治疗非HIV-PCP产生的可比存活率;然而，低剂量方案更好地耐受并且与较少的不良反应相关。

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