Trimethoprim-sulfamethoxazole treatment of Pneumocystis carinii pneumonia in adults.

Pneumocystis carinii pneumonia in the immunosuppressed patient is usually fatal if untreated.1 2 3 For several years, pentamidine isethionate has been considered the drug of choice for this infection.4 5 6 7 8 9 10 Although recovery rates ranging from 9 to 77 per cent have been reported with pentamidine,5 6 7 the rate of adverse reactions, primarily nephrotoxicity, has approached 50 per cent.5 6 7 , 9 , 11 Recently, Hughes and his colleagues at St. Jude Children's Research Hospital successfully used co-trimoxazole, the fixed combination of trimethoprim and sulfamethoxazole, to treat P. carinii pneumonia complicating childhood leukemia. In these studies, 16 of 20 patients recovered.12 Encouraged by this report and the need to assess . . .