1st International AIDS Conference Atlanta, Georgia, U.S.A. - April 14-17, 1985

Int Conf AIDS 1985 Apr 14-17; 1:23 (abstract no. S4C)

Jose Dryjanski, B Polsky, JWM Gold, EM Bernard, AE Brown, D Armstrong
Memorial Sloan-Kettering Cancer Center, New York City, New York.

The high incidence of adverse reactions to sulfamethoxazole-trimethoprim (SXT) in AIDS patients has resulted in an increased use of PI. The intramuscular (IM) route has been recommended due to the reported increase in adverse reactions with PI given by IV bolus. PI-IV has been used in 42 episodes of PCP in 37 AIDS patients at MSKCC. PI-IV was used as initial therapy in 6 episodes, in 24 after adverse reactions to SXT, in 4 after SXT alone had failed, and in combination with SXT in 8. PI-IV was given at 4 mg/kg/day by slow infusion (1-2 h). Peak serum concentrations ranged from 0.5-3.4 mcg/ml and the mean t1/2=17 4 min (n=3). Usual duration of PCP therapy was 21 days; median PI-IV therapy was 11 days (range 2-29). PI-IV toxicity occurred in 19 episodes (45%), in 14 patients (38%) and included: renal insufficiency (5), leukopenia (5), thrombocytopenia (4), nausea/vomiting (4), hypotension (2), hypoglycemia, rash, and diarrhea (1 each). Therapy was discontinued in 2 episodes due to toxicity; no deaths were attributable to PI-IV. PI-IV can be administered safely as an alternative to PI-IM in AIDS patients with PCP, with a response rate equivalent to SXT. A prospective trial comparing pharmacokinetics, toxicity, and efficacy of the 2 routes is justified.

850414
S4C

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