Evaluation of acetylator phenotype, renal function and serum sulfadiazine levels in patients with paracoccidioidomycosis treated with cotrimazine (a combination of sulfadiazine and trimethoprim)

✍ Scribed by Benedito Barraviera; Paulo Câmara Marques Pereira; Rinaldo P. Mendes; Jussara Marcondes Machado; Carlos Roberta G. Lima; Domingos Alves Meira

• Publisher: Springer Netherlands
• Year: 1989
• Tongue: English
• Weight: 432 KB
• Volume: 108
• Category: Article
• ISSN: 0301-486X
• DOI: 10.1007/bf00436060

✦ Synopsis

The authors evaluated the relationships among renal function, acetylator phenotype and serum sulfadiazine levels in 22 patients with paracoccidioidomycosis treated with 1 tablet of cotrimazine (a combination of 820 mg sulfadiazine and 180 mg trimethoprim) administered orally every 12 hours.

Fifteen patients (68.18 %) presented free sulfadiazine levels above 50 #g/ml, 6(27.28~o) presented serum levels above 40 #g/ml, and 1(4.54%), levels lower than 40 ffg/ml, this being the patient in which treatment failed. The highest free sulfadiazine levels were obtained in slow acetylator patients with reduced renal function. One patient with neuroparacoccidioidomycosis presented free sulfadiazine levels in cerebrospinal fluid corresponding to 55% of the serum levels.

Finally, the authors consider cotrimazine to be an important therapeutic alternative for neuroparacoccidioidomycosis and conclude that administration every 12 hours can provide therapeutic sulfadiazine levels. They also suggest that when the sulfadiazine-trimethoprim combination is used, the therapeutic levels of sulfadiazine should be above 40 #g/ml.