Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer
| Autor: | Caselli, D, Petris, Mg, Rondelli, R, Carraro, F, Colombini, A, Muggeo, P, Ziino, Melchionda, F, Russo, G, Pierani, P, Soncini, E, Desantis, R, Zanazzo, G, Barone, A, Cesaro, Simone, Cellini, M, Mura, R, Milano, Gm, Meazza, C, Cicalese, Mp, Tropia, S, De Masi, S, Castagnola, E, Aricò, M, Infectious Diseases Working Group of the Associazione Italiana Ematologia Oncologia Pediatrica |
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| Přispěvatelé: | Caselli, D, Petris, Mg, Rondelli, R, Carraro, F, Colombini, A, Muggeo, P, Ziino, O, Melchionda, F, Russo, G, Pierani, P, Soncini, E, Desantis, R, Zanazzo, G, Barone, A, Cesaro, S, Cellini, M, Mura, R, Milano, Gm, Meazza, C, Cicalese, Mp, Tropia, S, De Masi, S, Castagnola, E, Aricò, M, Infectious Diseases Working Group of the Associazione Italiana Ematologia Oncologia, Pediatrica. |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Pneumocystis carinii Pneumocystis pneumonia Drug Administration Schedule Anti-Infective Agents Internal medicine Trimethoprim Sulfamethoxazole Drug Combination medicine Humans Cumulative incidence Prospective Studies Child Prospective cohort study Intention-to-treat analysis Dose-Response Relationship Drug business.industry Pneumocystis (jirovecii [carinii]) pneumonia (PCP) Incidence Pneumonia Pneumocystis Sulfamethoxazole trimethoprim/sulfamethoxazole prophylaxis against PCP medicine.disease Trimethoprim Surgery Pneumonia Regimen Treatment Outcome Italy Hematologic Neoplasms Pediatrics Perinatology and Child Health business Follow-Up Studies medicine.drug |
| Popis: | Objective To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. Study design A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. Results The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. Conclusion A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases. |
| Databáze: | OpenAIRE |
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