Use of dapsone in the prevention and treatment of Pneumocystis carinii pneumonia

A review

Walter T. Hughes

Research output: Contribution to journalArticle

Abstract

Dapsone, with or without trimethoprim or pyrimethamine, has strong anti- Pneumocystis carinii activity, as demonstrated by in vitro methods, animal studies, and clinical trials. The drug blocks folic acid synthesis of P. carinii by inhibition of dihydropteroate synthetase activity. Dapsone is efficiently absorbed (70%-80%) from the gastrointestinal tract, reaches peak serum concentration in 2-6 hours, and is adequately distributed to the fluid of the alveolar spaces. Synergistic effects against P. carinii are noted when trimethoprim is combined with dapsone. This combination is recommended for therapeutic use for P. carinii pneumonia (PCP) as an alternative for patients who cannot take trimethoprim-sulfamethoxazole (TMP-SMZ). Evidence from more than 40 studies of dapsone as prophylaxis for PCP in AIDS patients shows that dapsone, either alone or in combination with pyrimethamine, is as effective as aerosolized pentamidine or atovaquone but slightly less effective than TMP-SMZ. Adverse effects include rash, anemia, methemoglobinemia, agranulocytosis, and hepatic dysfunction. Desensitization can be accomplished with many cases. Dapsone is the most cost-effective prophylaxis currently available for PCP.

Original languageEnglish (US)
Pages (from-to)191-204
Number of pages14
JournalClinical Infectious Diseases
Volume27
Issue number1
StatePublished - 1998
Externally publishedYes

Fingerprint

Dapsone
Pneumocystis Pneumonia
Pneumocystis carinii
Pyrimethamine
Trimethoprim
Sulfamethoxazole Drug Combination Trimethoprim
Dihydropteroate Synthase
Therapeutics
Atovaquone
Pentamidine
Methemoglobinemia
Agranulocytosis
Therapeutic Uses
Exanthema
Folic Acid
Gastrointestinal Tract
Anemia
Acquired Immunodeficiency Syndrome
Clinical Trials
Costs and Cost Analysis

ASJC Scopus subject areas

  • Immunology

Cite this

Use of dapsone in the prevention and treatment of Pneumocystis carinii pneumonia : A review. / Hughes, Walter T.

In: Clinical Infectious Diseases, Vol. 27, No. 1, 1998, p. 191-204.

Research output: Contribution to journalArticle

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