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Use of trimethoprim‐sulfamethoxazole in a patient with G6PD deficiency for treating Pneumocystis jirovecii pneumonia without haemolysis: Case report and literature review
Author(s) -
Lu YaWen,
Chen TsungChia
Publication year - 2020
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13220
Subject(s) - haemolysis , trimethoprim , medicine , sulfamethoxazole , human immunodeficiency virus (hiv) , pneumonia , pneumocystis jirovecii , population , surgery , dapsone , pediatrics , intensive care medicine , antibiotics , dermatology , virology , immunology , microbiology and biotechnology , environmental health , biology
What is known and objective A fixed dose of trimethoprim‐sulphamethoxazole (TMP/SMZ) is the first‐line therapy for Pneumocystis jirovecii pneumonia (PJP). Other alternative regiments have shown a suboptimal cure rate. However, TMP/SMZ has been reported to cause haemolyses when administered to patients with G6DP deficiency. PJP might be fatal without treatment. To date, there is still insufficient evidence to manage PJP with TMP/SMZ in G6DP deficiency population. Case description We report a G6PD‐deficient patient with human immunodeficiency virus (HIV) and PJP infection treated successfully with 21 days of high dose TMP/SMZ without any signs and symptoms of haemolysis. What is new and conclusion Based on our experience, it is worth to note that despite TMP/SMZ is consider unsafe in patient with pre‐existing G6PD‐deficiency, it could still be suggested as the initial drug of choice in Taiwanese or southeast Asian population for treating PJP infected HIV patient.