Effect of trimethoprim-sulfamethoxazole as Pneumocystis carinii pneumonia prophylaxis on bacterial illness, Pneumocystis carinii pneumonia, and death in persons with AIDS
Buskin, S.E.; Newcomer, L.M.; Koutsky, L.A.; Hooton, T.M.; Spach, D.H.; Hopkins, S.G.
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology Official Publication of the International Retrovirology Association 20(2): 201-206
1999
ISSN/ISBN: 1077-9450 PMID: 10048909 DOI: 10.1097/00042560-199902010-00014Document Number: 421155
To measure the effect of trimethoprim-sulfamethoxazole (TMP-SMX) in preventing bacterial illness, P. carinii pneumonia (PCP) and death in patients with AIDS, a retrospective medical record review was conducted including 1078 subjects who were observed for 3 years on average who attended 9 outpatient facilities in Seattle, Washington, USA, during January 1990-April 1996. Relative risk estimates were calculated to measure the protective effect of TMP-SMX on the development of major bacterial illnesses, PCP and death. Use of TMP-SMX decreased the risk of PCP (relative risk (RR)=0.23; 95% confidence interval (CI), 0.14-0.36) and deaths not attributable to PCP (RR=0.59; 95% CI, 0.47-0.73). Prevention of major bacterial illnesses of known aetiology was of borderline significance (RR=0.77; 95% CI, 0.57-1.05) and became statistically significant with the addition of patients with infections of unknown aetiology (RR=0.77; 95% CI 0.61-0.97). It is concluded that use of TMP-SMX PCP prophylaxis significantly reduces the risks of death and of PCP and is associated with a trend toward reduced risk of major bacterial infections.