ANN ARBOR--For many AIDS patients, treating a common type of pneumonia is problematic because they are allergic to the antibiotic proven to be most successful at fighting the infection. Now, researchers are reporting a breakthrough in helping those patients tolerate the medication.

In the longest running trial of its kind, doctors from the University of Michigan Medical Center and Brigham and Women's Hospital in Boston found that 86 percent of their HIV study patients were able to tolerate trimethoprim-sulfamethoxazole (also called Bactrim) after a previous allergic reaction. The results are reported in the November issue of the journal Allergy, Asthma and Immunology.

Bactrim is considered by the Centers for Disease Control to be the medication of choice in treating pneumocystis carinii pneumonia. However, there is a high incidence of fever and rash that forces up to a third of the patients to stop taking the drug.

The research team, headed by Powel Kazanjian, M.D., associate professor of internal medicine at the U-M Medical Center, designed a daily regimen of stepped-up dosages of Bactrim over an eight-day period. Patients were given incrementally larger oral doses over the eight days, ending up with a standard dose on day eight.

Kazanjian and his colleagues found that 86 percent of the HIV study patients were able to tolerate Bactrim after the eight-day regimen. Sixty percent tolerated the stepped-up dosages without problem. Another 26 percent were able to successfully take Bactrim, combined with a small dose of prednisone. The remaining study patients were forced to discontinue the program because of allergic reactions, none of which were life-threatening.

Kazanjian, who is director of the HIV/AIDS Program at U-M, says previous attempts to desensitize HIV patients have reported similar efficacies, but this study differs beca
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Contact: Pete Barkey
pbarkey@umich.edu
(313) 764-2220
University of Michigan
17-Nov-1997