RICHARD E. HELMER III, M.D.
To the editor: In the recent report of 194 cases of confirmed Pneumocystis carinii pneumonia, acute leukemia was the primary disorder in 35.5% (1). Pentamidine was used in the treatment. The regimen of pyrimethamine and sulfadiazine has been used successfully in the treatment of Pneumocystis carinii pneumonia (2). Pentamidine's side effects, the need for immediate therapy, and possible delay in obtaining pentamidine from the National Communicable Disease Center may make this alternative regimen even more attractive if clinical trials further substantiate its efficacy.
Pyrimethamine may produce megaloblastoid changes presumably related to folic acid or folinic acid antagonism (3). To obviate
HELMER RE. Hazard of Folinic Acid with Pyrimethamine and Sulfadiazine. Ann Intern Med. 1975;82:124–125. doi: 10.7326/0003-4819-82-1-124_2
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Published: Ann Intern Med. 1975;82(1):124-125.
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