Document 0258
 DOCN  M9590258
 TI    Outpatient bactrim desensitisation.
 DT    9509
 AU    Kelly M; Lloyd A; Furner V; Dept. Infectious Diseases PHH, Sydney.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:265 (unnumbered poster).
       Unique Identifier : AIDSLINE ASHM6/95291841
 AB    BACKGROUND: Bactrim is established as the drug of choice for
       Pneumocystis Carinii Pneumonia (P.C.P.) prophylaxis. More than 25% of
       HIV infected patients are unable to tolerate Bactrim because of
       hypersensitivity. Bactrim desensitisation in previously hypersensitive
       patients can be dangerous with deaths from anaphylaxis and Stevens
       Johnson Syndrome being reported. Despite these concerns, an inpatient
       desensitisation protocol has been established (by A.C.) and is in
       regular use in our hospitals. AIM: To develop a safe, convenient and
       effective Bactrim desensitisation protocol for previously hypersensitive
       HIV infected patients that could be administered in the outpatient
       setting. METHODS: 25 HIV infected patients with CD4 cell counts less
       than 200/microliters with a past history of Bactrim hypersensitivity
       were recruited. Over a four day period increasing doses of Bactrim were
       administered according to the following schema: TABULAR DATA, SEE
       ABSTRACT VOLUME. Patients take one single strength tablet (400mg) daily
       thereafter. The initial three doses are given under medical supervision
       in the clinic and the following doses are given at home in the company
       of a carer. The patient is reviewed in the clinic daily for 3 further
       days. RESULTS/CONCLUSIONS: Based on our inpatient experience we
       anticipate a high success rate and patient acceptance. The results of
       our study will be discussed.
 DE    Ambulatory Care  AIDS-Related Opportunistic Infections/*DRUG
       THERAPY/IMMUNOLOGY  CD4 Lymphocyte Count  Desensitization,
       Immunologic/*METHODS  Dose-Response Relationship, Drug  Drug
       Hypersensitivity/IMMUNOLOGY/*PREVENTION & CONTROL  Human  Pneumonia,
       Pneumocystis carinii/*DRUG THERAPY/IMMUNOLOGY
       Trimethoprim-Sulfamethoxazole Combination/ADMINISTRATION & DOSAGE/
       *ADVERSE EFFECTS/IMMUNOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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