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Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation

OBJECTIVE: Evaluate the effect of the combination of clindamycin with low-dose trimethoprim-sulfamethoxazole (TMP/SMX) regimen on sever Pneumocystis pneumonia (PCP) after renal transplantation. METHOD: 20 severe PCP patients after renal transplantation were included in this historical-control, retro...

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Autores principales: Gu, Zhun-Yong, Liu, Wen-Jun, Huang, Dan-Lei, Liu, Yu-Jing, He, Hong-Yu, Yang, Cheng, Liu, Yi-Mei, Xu, Ming, Rong, Rui-Ming, Zhu, Du-Ming, Luo, Zhe, Ju, Min-Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120531/
https://www.ncbi.nlm.nih.gov/pubmed/35602475
http://dx.doi.org/10.3389/fmed.2022.827850
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author Gu, Zhun-Yong
Liu, Wen-Jun
Huang, Dan-Lei
Liu, Yu-Jing
He, Hong-Yu
Yang, Cheng
Liu, Yi-Mei
Xu, Ming
Rong, Rui-Ming
Zhu, Du-Ming
Luo, Zhe
Ju, Min-Jie
author_facet Gu, Zhun-Yong
Liu, Wen-Jun
Huang, Dan-Lei
Liu, Yu-Jing
He, Hong-Yu
Yang, Cheng
Liu, Yi-Mei
Xu, Ming
Rong, Rui-Ming
Zhu, Du-Ming
Luo, Zhe
Ju, Min-Jie
author_sort Gu, Zhun-Yong
collection PubMed
description OBJECTIVE: Evaluate the effect of the combination of clindamycin with low-dose trimethoprim-sulfamethoxazole (TMP/SMX) regimen on sever Pneumocystis pneumonia (PCP) after renal transplantation. METHOD: 20 severe PCP patients after renal transplantation were included in this historical-control, retrospective study. A 10 patients were treated with the standard dose of TMP/SMX (T group), the other 10 patients were treated with the combination of clindamycin and low dose TMP/SMX (CT group). RESULTS: Although there was no significant difference in the hospital survival between the two groups, the CT protocol improved the PaO2/FiO2 ratio more significantly and rapidly after the 6th ICU day (1.51 vs. 0.38, P = 0.014). CT protocol also ameliorated the pulmonary infiltration and the lactate dehydrogenase level more effectively. Moreover, the CT protocol reduced the incidence of pneumomediastinum (0 vs. 50%, P = 0.008), the length of hospital staying (26.5 vs. 39.0 days, P = 0.011) and ICU staying (12.5 vs. 22.5 days, P = 0.008). Furthermore, more thrombocytopenia (9/10 vs. 3/10, P = 0.020) was emerged in the T group than in the CT group. The total adverse reaction rate was much lower in the CT group than in the T group (8/80 vs. 27/80, P < 0.001). Consequently, the dosage of TMP/SMX was reduced in 8 patients, while only 2 patients in the CT group received TMP/SMX decrement (P = 0.023). CONCLUSION: The current study proposed that clindamycin combined with low-dose TMP/SMX was more effective and safer the than single use of TMP/SMX for severe PCP patients after renal transplantation (NCT 04328688).
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spelling pubmed-91205312022-05-21 Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation Gu, Zhun-Yong Liu, Wen-Jun Huang, Dan-Lei Liu, Yu-Jing He, Hong-Yu Yang, Cheng Liu, Yi-Mei Xu, Ming Rong, Rui-Ming Zhu, Du-Ming Luo, Zhe Ju, Min-Jie Front Med (Lausanne) Medicine OBJECTIVE: Evaluate the effect of the combination of clindamycin with low-dose trimethoprim-sulfamethoxazole (TMP/SMX) regimen on sever Pneumocystis pneumonia (PCP) after renal transplantation. METHOD: 20 severe PCP patients after renal transplantation were included in this historical-control, retrospective study. A 10 patients were treated with the standard dose of TMP/SMX (T group), the other 10 patients were treated with the combination of clindamycin and low dose TMP/SMX (CT group). RESULTS: Although there was no significant difference in the hospital survival between the two groups, the CT protocol improved the PaO2/FiO2 ratio more significantly and rapidly after the 6th ICU day (1.51 vs. 0.38, P = 0.014). CT protocol also ameliorated the pulmonary infiltration and the lactate dehydrogenase level more effectively. Moreover, the CT protocol reduced the incidence of pneumomediastinum (0 vs. 50%, P = 0.008), the length of hospital staying (26.5 vs. 39.0 days, P = 0.011) and ICU staying (12.5 vs. 22.5 days, P = 0.008). Furthermore, more thrombocytopenia (9/10 vs. 3/10, P = 0.020) was emerged in the T group than in the CT group. The total adverse reaction rate was much lower in the CT group than in the T group (8/80 vs. 27/80, P < 0.001). Consequently, the dosage of TMP/SMX was reduced in 8 patients, while only 2 patients in the CT group received TMP/SMX decrement (P = 0.023). CONCLUSION: The current study proposed that clindamycin combined with low-dose TMP/SMX was more effective and safer the than single use of TMP/SMX for severe PCP patients after renal transplantation (NCT 04328688). Frontiers Media S.A. 2022-05-06 /pmc/articles/PMC9120531/ /pubmed/35602475 http://dx.doi.org/10.3389/fmed.2022.827850 Text en Copyright © 2022 Gu, Liu, Huang, Liu, He, Yang, Liu, Xu, Rong, Zhu, Luo and Ju. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Gu, Zhun-Yong
Liu, Wen-Jun
Huang, Dan-Lei
Liu, Yu-Jing
He, Hong-Yu
Yang, Cheng
Liu, Yi-Mei
Xu, Ming
Rong, Rui-Ming
Zhu, Du-Ming
Luo, Zhe
Ju, Min-Jie
Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title_full Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title_fullStr Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title_full_unstemmed Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title_short Preliminary Study on the Combination Effect of Clindamycin and Low Dose Trimethoprim-Sulfamethoxazole on Severe Pneumocystis Pneumonia After Renal Transplantation
title_sort preliminary study on the combination effect of clindamycin and low dose trimethoprim-sulfamethoxazole on severe pneumocystis pneumonia after renal transplantation
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120531/
https://www.ncbi.nlm.nih.gov/pubmed/35602475
http://dx.doi.org/10.3389/fmed.2022.827850
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