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Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review

(1) Background: Pneumocystis jirovecii pneumonia (PCP) has a substantial impact on the morbidity and mortality of patients, especially those with autoimmune disorders, thus requiring optimal dosing strategies of Trimethoprim–Sulfamethoxazole (TMP-SMX). Therefore, to ensure the safety of TMP-SMX, the...

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Autores principales: Haseeb, Abdul, Abourehab, Mohammed A. S., Almalki, Wesam Abdulghani, Almontashri, Abdulrahman Mohammed, Bajawi, Sultan Ahmed, Aljoaid, Anas Mohammed, Alsahabi, Bahni Mohammed, Algethamy, Manal, AlQarni, Abdullmoin, Iqbal, Muhammad Shahid, Mutlaq, Alaa, Alghamdi, Saleh, Elrggal, Mahmoud E., Saleem, Zikria, Radwan, Rozan Mohammad, Mahrous, Ahmad Jamal, Faidah, Hani Saleh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910260/
https://www.ncbi.nlm.nih.gov/pubmed/35270525
http://dx.doi.org/10.3390/ijerph19052833
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author Haseeb, Abdul
Abourehab, Mohammed A. S.
Almalki, Wesam Abdulghani
Almontashri, Abdulrahman Mohammed
Bajawi, Sultan Ahmed
Aljoaid, Anas Mohammed
Alsahabi, Bahni Mohammed
Algethamy, Manal
AlQarni, Abdullmoin
Iqbal, Muhammad Shahid
Mutlaq, Alaa
Alghamdi, Saleh
Elrggal, Mahmoud E.
Saleem, Zikria
Radwan, Rozan Mohammad
Mahrous, Ahmad Jamal
Faidah, Hani Saleh
author_facet Haseeb, Abdul
Abourehab, Mohammed A. S.
Almalki, Wesam Abdulghani
Almontashri, Abdulrahman Mohammed
Bajawi, Sultan Ahmed
Aljoaid, Anas Mohammed
Alsahabi, Bahni Mohammed
Algethamy, Manal
AlQarni, Abdullmoin
Iqbal, Muhammad Shahid
Mutlaq, Alaa
Alghamdi, Saleh
Elrggal, Mahmoud E.
Saleem, Zikria
Radwan, Rozan Mohammad
Mahrous, Ahmad Jamal
Faidah, Hani Saleh
author_sort Haseeb, Abdul
collection PubMed
description (1) Background: Pneumocystis jirovecii pneumonia (PCP) has a substantial impact on the morbidity and mortality of patients, especially those with autoimmune disorders, thus requiring optimal dosing strategies of Trimethoprim–Sulfamethoxazole (TMP-SMX). Therefore, to ensure the safety of TMP-SMX, there is a high demand to review current evidence in PCP patients with a focus on dose optimization strategies; (2) Methods: Various databases were searched from January 2000 to December 2021 for articles in English, focusing on the dose optimization of TMP-SMX. The data were collected in a specific form with predefined inclusion and exclusion criteria. The quality of each article was evaluated using a Newcastle–Ottawa Scale (NOS) for retrospective studies, Joanna Briggs Institute (JBI) critical checklist for case reports, and Cochrane bias tool for randomized clinical trials (RCTs); (3) Results: Thirteen studies met the inclusion criteria for final analysis. Of the 13 selected studies, nine were retrospective cohort studies, two case reports, and two randomized controlled trials (RCT). Most of the studies compared the high-dose with low-dose TMP-SMX therapy for PCP. We have found that a low dose of TMP-SMX provides satisfactory outcomes while reducing the mortality rate and PCP-associated adverse events. This strategy reduces the economic burden of illness and enhances patients’ compliance to daily regimen plan; (4) Conclusions: The large-scale RCTs and cohort studies are required to improve dosing strategies to prevent initial occurrence of PCP or to prevent recurrence of PCP in immune compromised patients.
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spelling pubmed-89102602022-03-11 Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review Haseeb, Abdul Abourehab, Mohammed A. S. Almalki, Wesam Abdulghani Almontashri, Abdulrahman Mohammed Bajawi, Sultan Ahmed Aljoaid, Anas Mohammed Alsahabi, Bahni Mohammed Algethamy, Manal AlQarni, Abdullmoin Iqbal, Muhammad Shahid Mutlaq, Alaa Alghamdi, Saleh Elrggal, Mahmoud E. Saleem, Zikria Radwan, Rozan Mohammad Mahrous, Ahmad Jamal Faidah, Hani Saleh Int J Environ Res Public Health Review (1) Background: Pneumocystis jirovecii pneumonia (PCP) has a substantial impact on the morbidity and mortality of patients, especially those with autoimmune disorders, thus requiring optimal dosing strategies of Trimethoprim–Sulfamethoxazole (TMP-SMX). Therefore, to ensure the safety of TMP-SMX, there is a high demand to review current evidence in PCP patients with a focus on dose optimization strategies; (2) Methods: Various databases were searched from January 2000 to December 2021 for articles in English, focusing on the dose optimization of TMP-SMX. The data were collected in a specific form with predefined inclusion and exclusion criteria. The quality of each article was evaluated using a Newcastle–Ottawa Scale (NOS) for retrospective studies, Joanna Briggs Institute (JBI) critical checklist for case reports, and Cochrane bias tool for randomized clinical trials (RCTs); (3) Results: Thirteen studies met the inclusion criteria for final analysis. Of the 13 selected studies, nine were retrospective cohort studies, two case reports, and two randomized controlled trials (RCT). Most of the studies compared the high-dose with low-dose TMP-SMX therapy for PCP. We have found that a low dose of TMP-SMX provides satisfactory outcomes while reducing the mortality rate and PCP-associated adverse events. This strategy reduces the economic burden of illness and enhances patients’ compliance to daily regimen plan; (4) Conclusions: The large-scale RCTs and cohort studies are required to improve dosing strategies to prevent initial occurrence of PCP or to prevent recurrence of PCP in immune compromised patients. MDPI 2022-02-28 /pmc/articles/PMC8910260/ /pubmed/35270525 http://dx.doi.org/10.3390/ijerph19052833 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Haseeb, Abdul
Abourehab, Mohammed A. S.
Almalki, Wesam Abdulghani
Almontashri, Abdulrahman Mohammed
Bajawi, Sultan Ahmed
Aljoaid, Anas Mohammed
Alsahabi, Bahni Mohammed
Algethamy, Manal
AlQarni, Abdullmoin
Iqbal, Muhammad Shahid
Mutlaq, Alaa
Alghamdi, Saleh
Elrggal, Mahmoud E.
Saleem, Zikria
Radwan, Rozan Mohammad
Mahrous, Ahmad Jamal
Faidah, Hani Saleh
Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title_full Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title_fullStr Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title_full_unstemmed Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title_short Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
title_sort trimethoprim-sulfamethoxazole (bactrim) dose optimization in pneumocystis jirovecii pneumonia (pcp) management: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910260/
https://www.ncbi.nlm.nih.gov/pubmed/35270525
http://dx.doi.org/10.3390/ijerph19052833
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