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Clindamycin with Primaquine vs. Trimethoprim-Sulfamethoxazole Therapy for Mild and Moderately Severe Pneumocystis carinii Pneumonia in Patients with AIDS: A Multicenter, Double-Blind, Randomized Trial (CTN 004)

1998; Oxford University Press; Volume: 27; Issue: 3 Linguagem: Inglês

10.1086/514696

1537-6591

Emil Toma, A. Thorne, Joel Singer, Janet Raboud, Camille Lemieux, Sylvie Trottier, Michelle Bergeron, Christos Tsoukas, Julian Falutz, R Lalonde, Christiane Gaudreau, René Therrien,

HIV/AIDS drug development and treatment

This double-blind, randomized, multicenter trial compared clindamycin/primaquine (Cm/Prq) with trimethoprim-sulfamethoxazole (TMP-SMZ) as therapy for AIDS-related Pneumocystis carinii pneumonia (PCP). Forty-five patients received clindamycin (450 mg four times daily [q.i.d.]) and primaquine (15 mg of base/d); 42 received TMP-SMZ (320 mg/1,600 mg q.i.d. if weight of ⩾60 kg or 240 mg/1,200 mg q.i.d. if weight of 70 mm Hg (P = .02, P = .04, and P = .02, respectively). For patients with PaO2 of ⩽70 mm Hg (23 Cm/Prq recipients and 21 TMP-SMZ recipients), the efficacy of Cm/Prq was similar to that of TMP-SMZ (success rate, 74% vs. 76%, respectively); Cm/Prq was associated with similar adverse events (P = .57), steroid use (P = .74), and rashes (P = .78). This trial confirms that Cm/Prq is a reasonable alternative therapy for mild and moderately severe PCP.