Does Low-Dose TMP-SMX Suffice for Non-HIV Pneumocystis Pneumonia?

Low-dose trimethoprim-sulfamethoxazole had similar or better outcomes than conventional high-dose treatment, with significantly fewer adverse events.

Standard treatment for pneumocystis pneumonia (PCP) — be it HIV-associated or secondary to another immunocompromising condition — is trimethoprim-sulfamethoxazole (TMP-SMX; TMP 15–20 mg/kg/day and SMX 75–100 mg/kg/day in 4 divided doses). However, a lower dose may have the same efficacy with fewer side effects (NEJM JW Infect Dis Dec 10 2015 and Infection 2015 Oct 15; [e-pub]).

Researchers in Japan conducted a retrospective cohort study involving 136 HIV-negative, immunocompromised patients (mean age, 71; 55% female) hospitalized with PCP between June 2006 and March 2021 who received different TMP-SMX doses for 14–21 days. In all, 55 received low-dose TMP-SMX (TMP <12.5 mg/kg/day; average dose, 8.7 mg/kg/day) and 81 received conventional-dos…

Reviewing Author

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Does Low-Dose TMP-SMX Suffice for Non-HIV Pneumocystis Pneumonia?

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Reviewing Author