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Protozoan infections-unresolved issues.
Powderly WG; Washington University, St. Louis, MO.
November 30, 1996
3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:174. Unique

Although there has been considerable progress in the treatment and prevention of Pneumocystis carinii pneumonia (PCP) in patients with AIDS, victory over this opportunistic infection has not been declared yet. Data from prospective clinical trials and from observational studies suggest that as many as 20% of patients with advanced HIV infection still develop PCP in spite of receiving standard recommended prophylaxis. This is mainly seen in patients unable to tolerate trimethoprim-sulfamethoxazole (TMP-SMZ) suggesting that finding better alternatives should become a priority, the basic nature of TMP-SMZ intolerance is poorly understood and strategies to overcome it and improve tolerance would greatly benefit from increased information as to its cause. However, TMP-SMZ failure also occurs and the possibility of resistance exists and has not yet been adequately addressed. In fact, there is much to be learned about the pathogenesis of PCPd that may help guide future therapeutic efforts. For toxoplasmosis, better therapy and diagnostic tests are needed. For the enteric protozoan pathogens the situation is even more daunting, although newer investigative strategies offer some promise.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Human Pneumonia, Pneumocystis carinii/COMPLICATIONS/*DRUG THERAPY/ PREVENTION & CONTROL Protozoan Infections/COMPLICATIONS/DRUG THERAPY/PREVENTION & CONTROL Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC USE ABSTRACT