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Preventing AIDS pneumonia.

Daily doses of the sulfa drug trimethoprim-sulfamethoxazole (TMP/SMX) help AIDS patients fend off recurrences of a life-threatening form of pneumonia more effectively than do monthly treatments with aerosolized pentamidine, according to a pair of studies comparing the two widely used preventive medications.

However, the authors of the studies conclude that because it produces fewer side effects than TMP/SMX, aerosolized pentamidine may still prove preferable for protecting some AIDS patients from Pneumocystis carinii pneumonia.

This form of pneumonia strikes many people with AIDS, and kills a large number of them. In the mid-1980s, physicians began prescribing pentamidine or TMP/SMX -- both of which are also used to treat established cases of Pneumocystis carinii pneumonia -- for AIDS patients as a preventive measure. Without such therapy, 65 percent of patients taking the anti-AIDS drug zidovudine (AZT) who survive an initial episode of the pneumonia suffer further bouts. In the first study, researchers led by Robert S. Holzman of New York University School of Medicine in New York City and W. David Hardy of the University of California, Los Angeles, found that 150 AIDS patients who inhaled an aerosol form of pentamidine once a month ran more than three times the risk of developing a recurrence of Pneumocystis carinii pneumonia as the same number of patients taking daily TMP/SMX. However, the researchers report in the Dec. 24 NEW ENGLAND JOURNAL OF MEDICINE, roughly one-fourth of the TMP/SMX patients had to stop taking the drug because it caused severe weakness or abdominal pain.

Researchers led by Margrit M.E. Schneider of the University Hospital Utrecht in the Netherlands report similar results in another study in the same journal. Schneider's team found that none of 142 AIDS patients taking daily TMP/SMX developed Pneumocystis carinii pneumonia, while six of 71 AIDS patients receiving pentamidine treatments monthly fell ill.
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Title Annotation:use of trimethoprim sulfamethoxazole may guard against pneumonia
Author:Ezzell, Carol
Publication:Science News
Article Type:Brief Article
Date:Jan 2, 1993
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