Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer

Désirée Caselli, Maria Grazia Petris, Roberto Rondelli, Francesca Carraro, Antonella Colombini, Paola Muggeo, Ottavio Ziino, Fraia Melchionda, Giovanna Russo, Paolo Pierani, Elena Soncini, Raffaella Desantis, Giulio Zanazzo, Angelica Barone, Simone Cesaro, Monica Cellini, Rossella Mura, Giuseppe M. Milano, Cristina Meazza, Maria P. Cicalese & 4 others Serena Tropia, Salvatore De Masi, Elio Castagnola, Maurizio Aricò

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. Study design A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. Results The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. Conclusion A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.

Original languageEnglish
JournalJournal of Pediatrics
Volume164
Issue number2
DOIs
Publication statusPublished - Feb 2014

Fingerprint

Pneumocystis Pneumonia
Sulfamethoxazole Drug Combination Trimethoprim
Neoplasms
Lymphoma
Leukemia
Pneumocystis carinii
Biological Factors
Hematology
Rheumatic Diseases
Pediatrics
Drug Therapy
Incidence

Keywords

  • AIEOP
  • Associazione Italiana Ematologia Oncologia Pediatrica
  • PCP
  • Pneumocystis (jirovecii [carinii]) pneumonia
  • SMX
  • Sulfamethoxazole
  • TMP
  • Trimethoprim

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Caselli, D., Petris, M. G., Rondelli, R., Carraro, F., Colombini, A., Muggeo, P., ... Aricò, M. (2014). Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer. Journal of Pediatrics, 164(2). https://doi.org/10.1016/j.jpeds.2013.10.021

Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer. / Caselli, Désirée; Petris, Maria Grazia; Rondelli, Roberto; Carraro, Francesca; Colombini, Antonella; Muggeo, Paola; Ziino, Ottavio; Melchionda, Fraia; Russo, Giovanna; Pierani, Paolo; Soncini, Elena; Desantis, Raffaella; Zanazzo, Giulio; Barone, Angelica; Cesaro, Simone; Cellini, Monica; Mura, Rossella; Milano, Giuseppe M.; Meazza, Cristina; Cicalese, Maria P.; Tropia, Serena; De Masi, Salvatore; Castagnola, Elio; Aricò, Maurizio.

In: Journal of Pediatrics, Vol. 164, No. 2, 02.2014.

Research output: Contribution to journalArticle

Caselli, D, Petris, MG, Rondelli, R, Carraro, F, Colombini, A, Muggeo, P, Ziino, O, Melchionda, F, Russo, G, Pierani, P, Soncini, E, Desantis, R, Zanazzo, G, Barone, A, Cesaro, S, Cellini, M, Mura, R, Milano, GM, Meazza, C, Cicalese, MP, Tropia, S, De Masi, S, Castagnola, E & Aricò, M 2014, 'Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer', Journal of Pediatrics, vol. 164, no. 2. https://doi.org/10.1016/j.jpeds.2013.10.021
Caselli, Désirée ; Petris, Maria Grazia ; Rondelli, Roberto ; Carraro, Francesca ; Colombini, Antonella ; Muggeo, Paola ; Ziino, Ottavio ; Melchionda, Fraia ; Russo, Giovanna ; Pierani, Paolo ; Soncini, Elena ; Desantis, Raffaella ; Zanazzo, Giulio ; Barone, Angelica ; Cesaro, Simone ; Cellini, Monica ; Mura, Rossella ; Milano, Giuseppe M. ; Meazza, Cristina ; Cicalese, Maria P. ; Tropia, Serena ; De Masi, Salvatore ; Castagnola, Elio ; Aricò, Maurizio. / Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer. In: Journal of Pediatrics. 2014 ; Vol. 164, No. 2.
@article{3e4d6d466f2440afb3e7cc472820b09b,
title = "Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer",
abstract = "Objective To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. Study design A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. Results The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6{\%}) received the 3-day/week prophylaxis regimen, 406 (16.5{\%}) received the 2-day/week regimen, and 689 (27.9{\%}), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08{\%}) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09{\%} overall (95{\%} CI, 0.00-0.40{\%}) and 0.51{\%} for the 2-day/week group (95{\%} CI, 0.10{\%}-2.00{\%}). Remarkably, both patients who failed had withdrawn from prophylaxis. Conclusion A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.",
keywords = "AIEOP, Associazione Italiana Ematologia Oncologia Pediatrica, PCP, Pneumocystis (jirovecii [carinii]) pneumonia, SMX, Sulfamethoxazole, TMP, Trimethoprim",
author = "D{\'e}sir{\'e}e Caselli and Petris, {Maria Grazia} and Roberto Rondelli and Francesca Carraro and Antonella Colombini and Paola Muggeo and Ottavio Ziino and Fraia Melchionda and Giovanna Russo and Paolo Pierani and Elena Soncini and Raffaella Desantis and Giulio Zanazzo and Angelica Barone and Simone Cesaro and Monica Cellini and Rossella Mura and Milano, {Giuseppe M.} and Cristina Meazza and Cicalese, {Maria P.} and Serena Tropia and {De Masi}, Salvatore and Elio Castagnola and Maurizio Aric{\`o}",
year = "2014",
month = "2",
doi = "10.1016/j.jpeds.2013.10.021",
language = "English",
volume = "164",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Single-day trimethoprim/sulfamethoxazole prophylaxis for pneumocystis pneumonia in children with cancer

AU - Caselli, Désirée

AU - Petris, Maria Grazia

AU - Rondelli, Roberto

AU - Carraro, Francesca

AU - Colombini, Antonella

AU - Muggeo, Paola

AU - Ziino, Ottavio

AU - Melchionda, Fraia

AU - Russo, Giovanna

AU - Pierani, Paolo

AU - Soncini, Elena

AU - Desantis, Raffaella

AU - Zanazzo, Giulio

AU - Barone, Angelica

AU - Cesaro, Simone

AU - Cellini, Monica

AU - Mura, Rossella

AU - Milano, Giuseppe M.

AU - Meazza, Cristina

AU - Cicalese, Maria P.

AU - Tropia, Serena

AU - De Masi, Salvatore

AU - Castagnola, Elio

AU - Aricò, Maurizio

PY - 2014/2

Y1 - 2014/2

N2 - Objective To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. Study design A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. Results The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. Conclusion A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.

AB - Objective To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. Study design A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. Results The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. Conclusion A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.

KW - AIEOP

KW - Associazione Italiana Ematologia Oncologia Pediatrica

KW - PCP

KW - Pneumocystis (jirovecii [carinii]) pneumonia

KW - SMX

KW - Sulfamethoxazole

KW - TMP

KW - Trimethoprim

UR - http://www.scopus.com/inward/record.url?scp=84892782742&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892782742&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2013.10.021

DO - 10.1016/j.jpeds.2013.10.021

M3 - Article

VL - 164

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 2

ER -