-
Views
-
Cite
Cite
Sharon Safrin, Belle L. Lee, Merle A. Sande, Adjunctive Folinic Acid With Trimethoprim-Sulfamethoxazole For Pneumocystis Carinii Pneumonia In Aids Patients Is Associated With An Increased Risk Of Therapeutic Failure And Death, The Journal of Infectious Diseases, Volume 170, Issue 4, October 1994, Pages 912–917, https://doi.org/10.1093/infdis/170.4.912
- Share Icon Share
Abstract
Ninety-two AIDS patients with Pneumocystis carinii pneumonia (PCP) were randomized to receive folinic acid or matching placebo in conjunction with trimethoprim-sulfamethoxazole in a prospective, double-blind trial. Neither frequency of dose-limiting toxicity (26% vs. 37%; P = .4) nor time to occurrence (P = .7) was associated with folinic acid use. Although incidence of neutropenia was lower in patients receiving folinic acid (23% vs. 47%; P = .03), time to occurrence of neutropenia did not differ (P = .4). Seven (7.6%) of92 patients with confirmed PCP met criteria for therapeutic failure, and 5 (6%) died during therapy. Surprisingly, folinic acid use was associated with a higher rate of both therapeutic failure (15% vs, 0; P = .01) and death (11% vs. 0; P = .06). Time to therapeutic failure was shorter and probability of death greater in patients receiving folinic acid (P = .005, P = .02, respectively), even when adjusted for baseline arterial oxygen pressure, serum lactate dehydrogenase, respiratory rate, CD4 cell count, and peak serum level of trimethoprim or sulfamethoxazole.