| アブストラクト | OBJECTIVES: Low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be a treatment option for patients with Pneumocystis jirovecii pneumonia (PCP). However, its effectiveness in patients without human immunodeficiency virus (HIV) infection has yet to be thoroughly investigated. METHODS: This retrospective cohort study used data extracted from the Japanese Diagnosis Procedure Combination inpatient database. We included immunocompromised patients without HIV having been diagnosed with PCP and had started TMP-SMX treatment between July 2010 and March 2022. We divided eligible patients into conventional-dose (15.0-20.0 mg/kg/d) and low-dose (7.5-15.0 mg/kg/d) groups and performed propensity-score overlap-weighting analysis. The primary outcome was in-hospital mortality rate. Secondary outcomes were completion of the initial treatment and use of alternatives to TMP-SMX for PCP treatment during hospitalization. RESULTS: Among 4449 eligible patients, 1682 (37.8 %) and 2767 (62.2 %) received conventional- and low-dose TMP-SMX treatments, respectively. No significant difference was observed in in-hospital mortality (risk difference, -1.4 %; 95 % CI, -4.5-1.7 %; P = 0.388). Low-dose TMP-SMX was associated with increased completion of initial treatment (risk difference, 4.6 %; 95 % CI, 2.3-6.9 %; P < 0.001), and reduced use of alternative agents (risk difference, -4.0 %; 95 % CI, -7.4 to -0.6 %; P = 0.020). CONCLUSION: Low-dose TMP-SMX may be a treatment option for patients with non-HIV PCP. |
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| ジャーナル名 | Infectious diseases now |
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| 投稿日 | 2024/10/6 |
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| 投稿者 | Taniguchi, Jumpei; Aso, Shotaro; Jo, Taisuke; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. Electronic address:;taniguchi-jumpei0825@g.ecc.u-tokyo.ac.jp.;Department of Real-World Evidence, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Graduate School of Medical and;Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39368745/ |
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