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Switch to atovaquone and subsequent re‐challenge with trimethoprim‐sulfamethoxazole for Pneumocystis prophylaxis in a kidney transplant population
Author(s) -
McLaughlin Milena M.,
Galal Audrey,
Richardson Chad L.,
Sutton Sarah H.,
Barr Viktorija O.,
Patel Niketa,
Mitchell Porntiwa,
Stosor Valentina
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12769
Subject(s) - medicine , sulfamethoxazole , trimethoprim , atovaquone , kidney transplant , population , adverse effect , pneumocystis pneumonia , pneumonia , kidney transplantation , kidney , pneumocystis jirovecii , immunology , antibiotics , malaria , microbiology and biotechnology , environmental health , plasmodium falciparum , biology
Kidney transplant recipients who are switched to atovaquone ( ATO ) from trimethoprim‐sulfamethoxazole ( TMP / SMX ) for Pneumocystis jirovecii pneumonia ( PJP ) prophylaxis because of adverse events or complications may miss opportunities to be re‐challenged with TMP / SMX , the first‐line agent. This single‐site, retrospective study assessed kidney transplant recipients for documented reasons for switching from TMP / SMX to alternate PJP prophylaxis and outcomes of TMP / SMX re‐challenge. Out of 166 patients, 155 initially received TMP / SMX ; of these, 31 were switched to ATO for various reasons. Fourteen patients receiving ATO were re‐challenged with TMP / SMX ; all were successfully re‐initiated on TMP / SMX therapy. Most patients switched to ATO post kidney transplant secondary to non‐hypersensitivity reasons should be re‐challenged with TMP / SMX because of the advantages it provides over other agents.