A CONTROLLED TRIAL OF AEROSOLIZED PENTAMIDINE OR TRIMETHOPRIM SULFAMETHOXAZOLE AS PRIMARY PROPHYLAXIS AGAINST PNEUMOCYSTIS-CARINII PNEUMONIA IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Background. Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) is recommended for patients with human immunodeficiency virus (HIV) infection if their CD4 cell counts are below 200 per cubic millimeter (0.2 x 10(9) per liter). Either aerosolized pentamidine or trimethoprim-sulfamethoxazole (co-trimoxazole) is commonly prescribed for prophylaxis, but the relative efficacy and toxicity of these agents are unknown. Methods. We conducted a multicenter trial involving 215 HIV-infected patients with no history of PCP but with CD4 cell counts below 200 per cubic millimeter. The patients were randomly assigned to one of three regimens: aerosolized pentamidine once a month, 480 mg of trimethoprim-sulfamethoxazole once a day (80 mg of trimethoprim and 400 mg of sulfamethoxazole), or 960 mg of trimethoprim-sulfamethoxazole once a day (160 mg and 800 mg, respectively). The cumulative incidence of PCP was estimated by Kaplan-Meier survival analysis. Results. After a mean follow-up of 264 days, 6 of the 71 patients in the pentamidine group had a confirmed first episode of PCP (11 percent), whereas none of the 142 patients in the two trimethoprim-sulfamethoxazole groups had PCP (P = 0.002). However, adverse events that required discontinuation of the medication were much more frequent in the trimethoprim-sulfamethoxazole groups (1 7 and 18 patients) than in the pentamidine group (2 patients). The adverse reactions occurred significantly sooner in the group given 960 mg of trimethoprim-sulfamethoxazole than in the group given 480 mg (mean time, 16 vs. 57 days; P = 0.02). Conclusions. For patients with HIV infection, trimethoprim-sulfamethoxazole taken once a day is more effective as primary prophylaxis against PCP than aerosolized pentamidine administered once a month, although adverse drug reactions are more frequent with trimethoprim-sulfamethoxazole

EFFICACY AND TOXICITY OF 2 DOSES OF TRIMETHOPRIM-SULFAMETHOXAZOLE AS PRIMARY PROPHYLAXIS AGAINST PNEUMOCYSTIS-CARINII PNEUMONIA IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS

The efficacy and toxicity of trimethoprim-sulfamethoxazole (TMP-SMZ) as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with human immunodeficiency virus (HIV) infection was assessed by comparing the effects of two dosages (480 or 960 mg once a day) of the drug. The multicenter trial involved 260 HIV-infected patients with CD4 cell count

EFFICACY AND TOXICITY OF 2 DOSES OF TRIMETHOPRIM-SULFAMETHOXAZOLE AS PRIMARY PROPHYLAXIS AGAINST PNEUMOCYSTIS-CARINII PNEUMONIA IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS

The efficacy and toxicity of trimethoprim-sulfamethoxazole (TMP-SMZ) as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with human immunodeficiency virus (HIV) infection was assessed by comparing the effects of two dosages (480 or 960 mg once a day) of the drug. The multicenter trial involved 260 HIV-infected patients with CD4 cell count

A High-resolution Muon Detector

The design and operation of precision drift chambers with multisampling as well as the concepts and methods for reaching an extraordinary degree of precision in mechanics and calibration are described. Specific instruments were developed for this purpose. The concept of reproducible positioning and the implementation to 30 mum accuracy, showing stability over three years, is given. Calibration and analysis with UV-laser and cosmic test measurements are outlined with the critical results. The experience of calibration and reliability of the large system in an actual L3 running experiment is analyzed. The resolution under ''battle conditions'' at LEP resulted in DELTAp/p = (2.50 +/- 0.04)% at 45.6 GeV and will be presented in detail. The concept is well suited for future TeV energies