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Adverse effects of trimethoprim–sulfamethoxazole for the prophylaxis of Pneumocystis pneumonia in dermatology
Author(s) -
Kokubu Hiraku,
Kato Takeshi,
Nishikawa Junko,
Tanaka Toshihiro,
Fujimoto Noriki
Publication year - 2021
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.15724
Subject(s) - medicine , adverse effect , trimethoprim , sulfamethoxazole , incidence (geometry) , pneumonia , dermatology , concomitant , pneumocystis pneumonia , pneumocystis jirovecii , antibiotics , physics , optics , microbiology and biotechnology , biology
Abstract Trimethoprim–sulfamethoxazole (TMP/SMX) combination is used for the prophylaxis of Pneumocystis pneumonia (PCP). Although TMP/SMX is frequently used in dermatology for cases treated with corticosteroids and/or immunosuppressants, it is often difficult to continue the administration of TMP/SMX due to adverse events. There are only a few reported studies on the prophylaxis of PCP in dermatology. This is the first review focused on adverse events of TMP/SMX among patients with dermatological diseases compared with previous reports. In this study, we retrospectively investigated 132 cases treated with TMP/SMX and examined the adverse events. Adverse events occurred in 32 cases (24.2%) and the incidence in this study was higher than in previous reports. Thrombocytopenia occurred in 17 cases (12.5%), which was the most frequent adverse event. The possible causes of adverse events were that the standard dose of TMP/SMX may be excessive for most Japanese, in addition to the long administration period, and the concomitant use of corticosteroids and/or immunosuppressants in almost all cases. We must consider the risks of PCP and adverse events of TMP/SMX in each case. It is desirable to examine possible administration methods that can be continued by adjusting the dose and interval of TMP/SMX.