{"id":24714,"date":"2023-12-04T04:12:00","date_gmt":"2023-12-03T20:12:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24714"},"modified":"2023-12-04T05:38:23","modified_gmt":"2023-12-03T21:38:23","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%b0%8f%e5%89%82%e9%87%8f%e4%b8%8e%e4%bc%a0%e7%bb%9f%e5%89%82%e9%87%8f%e5%a4%8d%e6%96%b9%e6%96%b0%e8%af%ba%e6%98%8e%e6%b2%bb%e7%96%97%e9%9d%9ehiv","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24714","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u5c0f\u5242\u91cf\u4e0e\u4f20\u7edf\u5242\u91cf\u590d\u65b9\u65b0\u8bfa\u660e\u6cbb\u7597\u975eHIV\u60a3\u8005\u7684\u80ba\u5b62\u5b50\u866b\u80ba\u708e"},"content":{"rendered":"\n

ORIGINAL RESEARCH|ARTICLES IN PRESS<\/a><\/p>\n\n\n\n

Low- Versus Conventional-Dose Trimethoprim-Sulfamethoxazole Treatment for Pneumocystis Pneumonia in Non-Human Immunodeficiency Virus-Infected Patients: A Multi-Center, Retrospective Observational Cohort Study<\/h1>\n\n\n\n

Tatsuya Nagai, Hiroki Matsui, Haruka Fujioka, et al<\/h3>\n\n\n\n

Chest Open AccessPublished:August 10, 2023<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2023.08.009<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Trimethoprim-sulfamethoxazole (TMP-SMX) is an effective treatment for Pneumocystis jirovecii<\/em> pneumonia (PCP) in immunocompromised patients with and without human immunodeficiency virus (HIV) infection; however, a high incidence of adverse events has been observed. Low-dose TMP-SMX is a potentially effective treatment with fewer adverse events; however, evidence is limited.<\/p>\n\n\n\n

Research question<\/h3>\n\n\n\n

What is the efficacy and safety of low-dose TMP-SMX for non-HIV PCP compared to conventional-dose TMP-SMX after adjusting for patient background characteristics?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

In this multicenter retrospective cohort study, we included patients diagnosed with non-HIV PCP and treated with TMP-SMX between June 2006 and March 2021 at three institutions. The patients were classified into low- (TMP <12.5 mg\/kg\/day) and conventional-dose groups (TMP 12.5\u201320 mg\/kg\/day). The primary endpoint was 30-day mortality, and the secondary endpoints were 180-day mortality, adverse events of grade 3 or greater per the Common Terminology Criteria for Adverse Events v5.0, and initial treatment completion rates. Background characteristics were adjusted using the overlap weighting method with propensity scores.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Fifty-five patients in the low-dose and 81 in the conventional-dose groups were evaluated. In the overall cohort, the average age was 70.7 years, and the proportion of females was 55.1%. The average dose of TMP-SMX was 8.71 mg\/kg\/day in the low-dose group and 17.78 mg\/kg\/day in the conventional-dose group. There was no significant difference in 30-day mortality (6.7% vs. 18.4%,\u00a0P<\/em>=0.080) or 180-day mortality (14.6% vs. 26.1%,\u00a0P<\/em>=0.141) after adjusting for patient background characteristics. The incidence of adverse events, especially nausea and hyponatremia, was significantly lower in the low-dose group (29.8% vs. 59.0%,\u00a0P<\/em>=0.005). The initial treatment completion rates were 43.3% and 29.6% in the low-dose and conventional-dose groups (P<\/em>=0.158), respectively.<\/p>\n\n\n\n

Interpretation<\/h3>\n\n\n\n

Survival was similar between the low- and conventional-dose TMP-SMX groups, and low-dose TMP-SMX was associated with reduced adverse events in patients with non-HIV PCP.<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL RESEARCH|ARTICLES IN PRESS Low- Versus Convent […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24714"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24714"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24714\/revisions"}],"predecessor-version":[{"id":24715,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24714\/revisions\/24715"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24714"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24714"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24714"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}