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Pneumocystis carinii Pneumonia prophylaxis with atovaquone in trimethoprim‐sulfamethoxazole–intolerant orthotopic liver transplant patients: A preliminary study
Author(s) -
Meyers Burt,
Borrego Fernando,
Papanicolaou Genovefa
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.26433
Subject(s) - medicine , atovaquone , pneumocystis carinii , pneumonia , adverse effect , sulfamethoxazole , trimethoprim , gastroenterology , rash , bone marrow suppression , toxicity , surgery , immunology , antibiotics , plasmodium falciparum , malaria , microbiology and biotechnology , biology , pneumocystis jirovecii
Pneumocystis carinii pneumonia (PCP) is an opportunistic infection associated with increased morbidity and mortality in solid‐organ and bone‐marrow transplant recipients. Side effects of trimethoprim‐sulfamethoxazole (TMP/SMX) are frequent; therefore, we performed a preliminary study using atovaquone suspension, 750 mg once daily, for 1 year for the prevention of PCP in liver transplant recipients intolerant to TMP/SMX therapy. Twenty‐eight patients were treated, and data were analyzed for efficacy and toxicity. Adverse events occurred in 14 subjects, mainly related to the gastrointestinal tract. Side effects from TMP/SMX, i.e., rash, completely resolved and bone‐marrow suppression improved in 62% of patients. No patients developed Pneumocystis carinii infection. Although a lower dose of atovaquone once daily may be effective in transplant recipients, further studies are necessary to confirm this preliminary observation.