1. Atovaquone Compared with Dapsone for the Prevention ofPneumocystis cariniiPneumonia in Patients with HIV Infection Who Cannot Tolerate Trimethoprim, Sulfonamides, or Both
- Author
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Richard Hafner, Charles van der Horst, Robert L. Murphy, Thomas M. Hooton, Henry H. Balfour, Wafaa El-Sadr, Roberta Luskin-Hawk, Thomas Kerkering, Tony W. Cheung, Teresa Yurik, Robert H.K. Eng, and Malte Schutz
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Sulfamethoxazole ,General Medicine ,Dapsone ,biology.organism_classification ,medicine.disease ,Trimethoprim ,Pneumonia ,Pneumocystis carinii ,Internal medicine ,Relative risk ,Immunology ,medicine ,Sida ,business ,Atovaquone ,medicine.drug - Abstract
Background Although trimethoprim–sulfamethoxazole is the drug of choice for the prevention of Pneumocystis carinii pneumonia, many patients cannot tolerate it and must switch to an alternative agent. Methods We conducted a multicenter, open-label, randomized trial comparing daily atovaquone (1500-mg suspension) with daily dapsone (100 mg) for the prevention of P. carinii pneumonia among patients infected with the human immunodeficiency virus who could not tolerate trimethoprim–sulfamethoxazole. The median follow-up period was 27 months. Results Of 1057 patients enrolled, 298 had a history of P. carinii pneumonia. P. carinii pneumonia developed in 122 of 536 patients assigned to atovaquone (15.7 cases per 100 person-years), as compared with 135 of 521 in the dapsone group (18.4 cases per 100 person-years; relative risk for atovaquone vs. dapsone, 0.85; 95 percent confidence interval, 0.67 to 1.09; P=0.20). The relative risk of death was 1.07 (95 percent confidence interval, 0.89 to 1.30; P=0.45), and the r...
- Published
- 1998