Importance of drug monitoring for compound sulfamethoxazole therapy in patients with <i>Pneumocystis jiroveci</i> pneumonia

Abstract

Abstract:

Pneumocystis jirovecipneumonia (PJP) is one of the more common and serious opportunistic infections in patients with human immunodeficiency virus (HIV). With the use of immunosuppressants and chemotherapy drugs, most PJP cases reported in China are non-HIV immunosuppressed patients. Compound sulfamethoxazole (SMZco) is the first-line drug for the treatment of PJP, and there are wide individual differences in its pharmacokinetics. Through citing a PJP case treated with SMZco under drug monitoring, a systematic review was conducted from the aspects of SMZco pharmacokinetics, dose-related adverse reactions, and optimal therapeutic dose research. It aims to demonstrate the importance of drug monitoring for sulfamethoxazole therapy, which ensures the drug reaches effective therapeutic concentrations and the occurrence of its’ adverse reactions was reduced.

Key words:Pneumocystis jirovecipneumonia,Compound sulfamethoxazole,Therapeutic drug monitoring

CLC Number:

R563.1

FANG Jie, CHEN Chao, ZHOU Min. Importance of drug monitoring for compound sulfamethoxazole therapy in patients withPneumocystis jirovecipneumonia[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(01): 31-36.

Figures/Tables3

Figure 1

Figure 2

Table 1

SMZco dose, serum potassium concentration, C-reactive protein ， procalcitonin and serum drug concentration during treatment

用药时间*	给药剂量	检测时间*	血钾浓度(μmol/L)	C反应蛋白(mg/L)	降钙素原(ng/mL)	C_min(μg/mL)	C_max(μg/mL)
		D1		132
		D2		142	2.04
D3~D11	0.96g/次，qid	D3	3.96	89	2.15
		D4	4.01	57	1.47
		D5	4.26	24	0.79		125
		D6	4.67	15	0.48
		D7	5.24	10
		D8	5.14	8	0.24
		D9	6.24	7	0.28		188
		D10	5.49	16	0.51
D12~D14	0.96 g/次，q12h	D12	5.01	17	0.74
D12~D14	0.96 g/次，q12h	D14	4.32	29	0.7
D15~D37	0.96 g/次，tid	D15		24	0.5		59.7
		D20	5.07
		D23	4.93	8	0.23		94.99
		D29	4.37			96.84
		D32	3.98			115.35
		D36	4.43	7	0.12	100.27
		D37		7

Table 1

References24

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Importance of drug monitoring for compound sulfamethoxazole therapy in patients withPneumocystis jirovecipneumonia

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