摘要:

We developed a decision-analytic model to assess the effectiveness and costs of dapsone, trimethoprim-sulfamethoxazole, or aerosolized pentam-idine as initial prophylaxis forPneumocystis cariniipneumonia in human immunodeficiency virus-infected people without prior symptoms AIDS and with CD4 counts <200/mm3. Each strategy increased life expectancy by about 18% compared with no prophylaxis; annual per-person costs were $440, $700, and $1,680 for dapsone, trimethoprim-sulfamethoxazole, and aerosolized pentam-idine, respectively. These cost differences make a strategy beginning with dapsone most cost effective, with an incremental cost-effectiveness ratio of $13,400 per life year saved compared with no prophylaxis. Aerosolized pent-amidine was substantially less cost effective, but the incremental cost effectiveness ratios were highly dependent on estimates for quality of life, efficacy, toxicity, and compliance. We conclude that, based on currently available data, initial prophylaxis with either dapsone or trimethoprim-sulfamethoxazole is most cost effective. For every 100,000 people treated, starting prophylaxis with trimethoprim-sulfamethoxazole or dapsone—with crossover to aerosolized pentamidine if oral therapy is not tolerated—may save between $98 million and $124 million per year.

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Pneumocystis cariniipneumonitis was effectively prevented in 90% of immunosuppressed rats by the administration of 100 mg of erythromycin and 300 mg/kg/day of sulfisoxazole. All of the untreated control and erythromycin-treated animals developed the infection and 80% of rats given sulfisoxazole alone had the pneumonitis. A similar pattern of response occurred when the drugs were used therapeutically for rats with establishedP. cariniipneumonitis. The erythromycin and sulfisoxazole ratio of 1:3 was the most effective of several dose combinations tested. The established safety record from three decades of clinical use of this drug combination plus the broad spectrum of coverage for other causes of diffuse pneumonitis such asChlamydia, Mycoplasma, andLegionellawarrant further study of erythromycin-sulfisoxazole in AIDS patients.

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Dideoxycytidine (ddC) and dideoxyinosine (ddI) are nucleoside derivatives that exhibit antiretroviral activity against the human immunodeficiency virus (HIV). Both of these agents are under active investigation as potential therapies for patients with HIV infection. In addition, both drugs may be obtained for HIV-infected individuals who cannot tolerate zidovudine. A major focus of the research effort involving these agents has been to define their toxicities. Both agents may cause peripheral neuropathy. We wish to report a patient who developed severe neuropathy following the administration of ddI that was given shortly after the patient was removed from a clinical trial of ddC. The rapid development of toxicity indicates that this side effect is additive or synergistic for these agents.

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1991

数据来源: OVID