       Document 0480
 DOCN  M9640480
 TI    Adverse cutaneous reactions to pyrimethamine/sulfadiazine and
       pyrimethamine/clindamycin in patients with AIDS and toxoplasmic
       encephalitis.
 DT    9604
 AU    Caumes E; Bocquet H; Guermonprez G; Rogeaux O; Bricaire F; Katlama C;
       Gentilini M; Departement des Maladies Infectieuses, Parasitaires,
       Tropicales,; et Sante Publique, Hopital Pitie-Salpetriere, Paris,
       France.
 SO    Clin Infect Dis. 1995 Sep;21(3):656-8. Unique Identifier : AIDSLINE
       MED/96077391
 AB    We assessed the value of clinical and laboratory parameters for
       predicting the occurrence of skin reactions induced by
       pyrimethamine/sulfadiazine and pyrimethamine/clindamycin and the effects
       of continued therapy for patients with these reactions. We
       retrospectively studied all episodes of toxoplasmic encephalitis in
       patients with AIDS who were treated with pyrimethamine/sulfadiazine or
       pyrimethamine/clindamycin. Eighteen (75%) of 24 patients treated with
       pyrimethamine/sulfadiazine had cutaneous reactions after a mean of 11
       days, whereas 15 (58%) of 26 patients treated with
       pyrimethamine/clindamycin had cutaneous reactions after a mean of 13
       days (P = .56). Nine (50%) of the 18 patients continued to be treated
       with pyrimethamine/sulfadiazine throughout the duration of
       hypersensitivity, compared with all 15 patients who were treated with
       pyrimethamine/clindamycin (P = .002). Nine patients had to stop therapy
       with pyrimethamine/sulfadiazine (two had Stevens-Johnson syndrome and
       one had Lyell's syndrome). Thus, treatment throughout the duration of
       hypersensitivity is more likely to succeed for patients receiving
       pyrimethamine/clindamycin, whereas therapy with
       pyrimethamine/sulfadiazine is associated with a high risk of Lyell's
       syndrome and Stevens-Johnson syndrome.
 DE    Adult  Anti-Infective Agents/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS
       Antibiotics/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS  AIDS-Related
       Opportunistic Infections/*DRUG THERAPY  Clindamycin/ADMINISTRATION &
       DOSAGE/*ADVERSE EFFECTS  Comparative Study  Drug Eruptions/*ETIOLOGY
       Drug Therapy, Combination  Encephalitis/*COMPLICATIONS/*DRUG THERAPY
       Epidermal Necrolysis, Toxic/ETIOLOGY  Female  Human  Male  Middle Age
       Pyrimethamine/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS  Retrospective
       Studies  Risk Factors  Stevens-Johnson Syndrome/ETIOLOGY
       Sulfadiazine/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS  Toxoplasmosis,
       Cerebral/*COMPLICATIONS/*DRUG THERAPY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

