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May 1978

Delayed Development of Pneumocystis Pneumonia Following Administration of Short-Term High-Dose Trimethoprim-Sulfamethoxazole

Author Affiliations

Department of Pediatrics Indiana University School of Medicine James Whitcomb Riley Hospital for Children Indianapolis, IN 46202

Am J Dis Child. 1978;132(5):525-526. doi:10.1001/archpedi.1978.02120300085018

The incidence of opportunistic pulmonary infections in children with cancer who receive intensive immunosuppressive chemotherapy has increased. Pneumocystis carinii pneumonia (PCP) is a frequent cause of death in patients with acute lymphoblastic leukemia (ALL) who remain in complete remission.1.2 At our institution, from Jan 1, 1975 to Dec 31, 1975, the incidence of PCP in children with ALL was 12% (11 of 89) while in patients with solid tumors the attack rate was 2% (one in 45). All patients with ALL in whom PCP developed were in remission and with only one exception, PCP occurred between days 40 and 90 from the onset of chemotherapy. Since PCP has been treated effectively in adults as well as children with a two-week course of high-dose Trimethoprim-Sulfamethoxazole (TMP-SMZ),3.4 we evaluated the prophylactic value of this regimen in a random fashion in children with ALL who were in the first 100 days