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Dapsone-Trimethoprim for Pneumocystis carinii Pneumonia in the Acquired Immunodeficiency Syndrome

GIFFORD S. LEOUNG, M.D.; JOHN MILLS, M.D.; PHILIP C. HOPEWELL, M.D.; WALTER HUGHES, M.D.; and CONSTANCE WOFSY, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Philip C. Hopewell, M.D.; Chest Service, Room 5K1, San Francisco General Hospital, 1001 Potrero Avenue; San Francisco, CA 94110.


San Francisco, California; and Memphis, Tennessee


© 1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;105(1):45-48. doi:10.7326/0003-4819-105-1-45
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All patients with the acquired immunodeficiency syndrome and a first episode of Pneumocystis carinii pneumonia seen at the San Francisco General Hospital between November 1984 and April 1985 were evaluated for oral treatment with dapsone (100 mg/d) plus trimethoprim (20 mg/kg body weight · d). All 15 patients who met the entry criteria improved clinically and radiographically within 3 to 10 days after starting treatment. Repeat pulmonary function tests and gallium lung scans after 3 weeks of therapy also showed improvement. Although side effects occurred in 14 patients, in only 2 were they severe enough to require stopping therapy. Both of these patients had worsening skin rash, and dapsonetrimethoprim therapy was stopped after 10 days. When compared with trimethoprim-sulfamethoxazole or pentamidine used to treat P. carinii pneumonia in similar patients, oral dapsone-trimethoprim is at least as effective, seems to be better tolerated, and may have a lower frequency of serious side effects.

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