Document 0922
 DOCN  M9470922
 TI    Effect of corticosteroids on the incidence of adverse cutaneous
       reactions to trimethoprim-sulfamethoxazole during treatment of
       AIDS-associated Pneumocystis carinii pneumonia.
 DT    9409
 AU    Caumes E; Roudier C; Rogeaux O; Bricaire F; Gentilini M; Departement des
       Maladies Infectieuses, Parasitaires, Tropicales,; et Sante Publique,
       Hopital Pitie-Salpetriere, Paris, France.
 SO    Clin Infect Dis. 1994 Mar;18(3):319-23. Unique Identifier : AIDSLINE
       MED/94281409
 AB    We retrospectively studied all courses of treatment with
       trimethoprim-sulfamethoxazole (TMP-SMZ) alone and with adjuvant
       corticosteroids for AIDS-associated Pneumocystis carinii pneumonia. The
       corticosteroids were administered for 8-21 days (mean, 14 days) because
       of hypoxemia. We evaluated the influence of corticosteroids on the
       incidence of cutaneous adverse reactions to TMP-SMZ and on the course of
       AIDS during 3 months of follow-up. Of 38 patients treated with TMP-SMZ
       alone, 18 (47%) developed cutaneous side effects, whereas three (13%) of
       the 23 patients who received adjuvant corticosteroid therapy experienced
       such effects (P = .014). Of the 21 reactive patients, 14 were treated
       throughout the duration of hypersensitivity. Therapy was interrupted for
       seven patients (18%) treated with TMP-SMZ alone and for none of those
       who were given adjuvant corticosteroid therapy (P = .23). During
       follow-up, the incidence of mucocutaneous herpes simplex virus infection
       was higher among patients who received adjuvant corticosteroids than
       among those treated with TMP-SMZ alone (P = .005). Adjuvant
       corticosteroids thus reduce the incidence of adverse cutaneous reactions
       to TMP-SMZ in patients with AIDS who are treated for hypoxemic P.
       carinii pneumonia.
 DE    Adrenal Cortex Hormones/*ADMINISTRATION & DOSAGE  Adult  AIDS-Related
       Opportunistic Infections/COMPLICATIONS/*DRUG THERAPY  Drug
       Eruptions/ETIOLOGY/PREVENTION & CONTROL  Female  Human  Male  Middle Age
       Pneumonia, Pneumocystis carinii/COMPLICATIONS/*DRUG THERAPY
       Retrospective Studies  Trimethoprim-Sulfamethoxazole
       Combination/*ADMINISTRATION &  DOSAGE/*ADVERSE EFFECTS  CLINICAL TRIAL
       JOURNAL ARTICLE

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