Journal Article

Ineffectiveness of Trimethoprim-Sulfamethoxazole Prophylaxis and the Importance of Bacterial and Viral Coinfections in African Children with <i>Pneumocystis carinii</i> Pneumonia

Shabir A Madhi, Clare Cutland, Kuraisha Ismail, Cathryn O'Reilly, Archana Mancha and Keith P Klugman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 9, pages 1120-1126
Published in print November 2002 | ISSN: 1058-4838
Published online November 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/343049
Ineffectiveness of Trimethoprim-Sulfamethoxazole Prophylaxis and the Importance of Bacterial and Viral Coinfections in African Children with Pneumocystis carinii Pneumonia

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African human immunodeficiency virus type 1 (HIV-1)–infected children were evaluated to define the burden of Pneumocystis carinii pneumonia (PCP) and its interaction with bacterial and viral pathogens. P. carinii was identified in 101 (43.7%) of 231 episodes of pneumonia among 185 HIV-1–infected children (median age, 4.5 months; range, 1.7–27.3 months). Receipt of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis was not associated with a significant reduction (36%; 95% confidence interval [CI], -15.4% to 64.5%) in isolation of P. carinii among children considered to have received adequate prophylaxis (37.7% of children) compared with children who had never received any prophylaxis (48.5% of children). However, deaths among children with PCP who had been taking TMP-SMX prophylaxis were markedly reduced (98.6%; 95% CI, 89.1%–99.8%) compared with children who were not taking prophylaxis. Concurrent P. carinii infection was observed in 6 of 18, 11 of 26, and 4 of 6 HIV-1–infected children who had bacteremia, a respiratory virus isolated, or Mycobacterium species isolated, respectively.

Journal Article.  4238 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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