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Correspondence
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Volume 328:1569 May 27, 1993 Number 21
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Prevention and Treatment of Pneumocystis Pneumonia

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To the Editor: Masur (Dec. 24 issue)1 reviewed the prevention and treatment of Pneumocystis carinii pneumonia (PCP). Two strategies to reduce the toxic effects of trimethoprim-sulfamethoxazole in patients infected with the human immunodeficiency virus (HIV) are worth pursuing. First, one study has suggested that giving 960 mg of trimethoprim-sulfamethoxazole three days a week can prevent PCP, with fewer side effects2. The longer drug-free intervals may facilitate the removal of the accumulated toxic metabolites of sulfamethoxazole. Second, van der Ven et al. have suggested the use of N-acetylcysteine therapy to replenish depleted stores of glutathione in persons with HIV infection3. . . [Full Text of this Article]

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