Twice-weekly dapsone for primary prophylaxis against Pneumocystis carinii pneumonia in HIV-1 infection: Efficacy, safety and pharmacokinetic data

M. Cruciani, E. Bertazzoni Minelli, M. Mirandola, R. Luzzati, M. Merighi, L. Lazzarini, G. Gatti, S. Vento, R. Mazzi, M. Malena, A. Benini, A. Cazzadori, G. Piemonte, D. Bassetti, E. Concia

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Abstract

Objectives: In this study we evaluated the pharmacokinetics, efficacy and safety of dapsone given 100 mg twice weekly as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) in patients with HIV-1 infection. Methods: This was a prospective open trial, evaluating a total of 55 HIV-1-infected patients with CD4 cell counts below 200/mm3 and without previous episodes of PCP. Plasma concentrations of dapsone were determined with high-performance liquid chromatography (HPLC). After a mean follow-up of 471 days, the PCP rates per year of observation were 6.79%. Discontinuation of treatment as a result of severe side effects was required in four patients (7.5%). At steady state, mean plasma concentrations 24, 72, 96 and 144 h following the administration of dapsone were 1.46±0.8, 0.28±0.20, 0.30±0.21 and 0.37±0.27 mg/L, respectively. Dapsone plasma levels showed a high interpatient variability. The values for the pharmacokinetic parameters were comparable to those described for healthy volunteers. Conclusions: The administration of 100 mg twice weekly of dapsone seems appropriate to maintain effective plasma concentrations of the drug and to prevent PCP with good safety in patients with HIV-1-related immunodeficiency.

Original languageEnglish
Pages (from-to)30-35
Number of pages6
JournalClinical Microbiology and Infection
Volume2
Issue number1
DOIs
Publication statusPublished - Aug 1996

Keywords

  • Dapsone
  • Pharmacokinetics
  • Pneumocystis carinii pneumonia prophylaxis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Cruciani, M., Bertazzoni Minelli, E., Mirandola, M., Luzzati, R., Merighi, M., Lazzarini, L., Gatti, G., Vento, S., Mazzi, R., Malena, M., Benini, A., Cazzadori, A., Piemonte, G., Bassetti, D., & Concia, E. (1996). Twice-weekly dapsone for primary prophylaxis against Pneumocystis carinii pneumonia in HIV-1 infection: Efficacy, safety and pharmacokinetic data. Clinical Microbiology and Infection, 2(1), 30-35. https://doi.org/10.1111/j.1469-0691.1996.tb00197.x