Low-Cost Help for AIDS Cases : Treatment: Drug costing a few dollars a month is effective in preventing pneumonia related to the illness, according to study by Los Angeles doctors.
A low dose of an inexpensive oral medication is effective in preventing a severe AIDS-related pneumonia, according to a new study by two physicians at the Kaiser Permanente Los Angeles Medical Center.
The study of 116 patients supports the use of trimethoprim/sulfamethoxazole to avoid the development of Pneumocystis carinii pneumonia, the most common life-threatening complication of AIDS. The medication is better known by the brand names Bactrim or Septra.
But the research, being published today in The Lancet, a British medical journal, is unlikely to settle the question of what is the best medication to protect against the pneumonia. This is because all the patients received the inexpensive drug and none received the other leading preventive treatment, aerosol pentamidine, which is far more expensive.
Direct comparisons of trimethoprim/sulfamethoxazole and aerosol pentamidine are under way as part of nationwide federally funded AIDS studies. Results are expected later this year or in 1992.
Nevertheless, Drs. Joel Ruskin and Marc LaRiviere, the authors of the study, maintained that trimethoprim/sulfamethoxazole was better than aerosol pentamidine. This “offers advantages over what is currently being done,” LaRiviere said.
A month’s supply of a generic version of trimethoprim/sulfamethoxazole, taken orally three times a week as in the study, could cost a patient $1 to $2. By comparison, aerosol pentamidine, given as an inhalation medication directly to the lungs once a month, often costs $200 or more a treatment.
The patients in the study were chosen from a Kaiser computer listing of patients with AIDS and AIDS-related conditions. Some had already had cases of the pneumonia.
The patients’ medical records were followed up through June, 1990, or the time of death. The typical patient was followed for about 18 months. Almost all the patients were homosexual men.
Two-thirds of the patients had died by the conclusion of the study. But the researchers were encouraged because none developed the AIDS-related pneumonia while receiving the trimethoprim/sulfamethoxazole.
About one-quarter of the patients experienced medication side effects, such as a rash; 9% stopped the drug within the first month.
One of the reasons that the researchers found a lower rate of side effects than in previous studies was the relatively low dose of trimethoprim/sulfamethoxazole used. The dose was one “double strength” tablet three times a week, compared to two such tablets daily, a dose that has been previously recommended to prevent the pneumonia.
