ArticleJournal of pharmaceutical health care and sciences2026
Clinical outcomes after switching from sulfamethoxazole-trimethoprim to atovaquone due to intolerance in patients with non-HIV Pneumocystis pneumonia: a single-center retrospective study.
Article in Journal of pharmaceutical health care and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Prophylaxis Regimens forJournal of fungi (Basel, Switzerland) · 2026Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtovaquone (Atov), a second-line drug, is used to treat patients with Pneumocystis pneumonia (PCP) who cannot tolerate sulfamethoxazole/trimethoprim (SMX/TMP). However, the efficacy and safety of Atov are based on clinical trials conducted in patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome, with limited data available on HIV-uninfected individuals with PCP (non-HIV PCP). In this study, we retrospectively evaluated the clinical outcomes of switching from SMX/TMP to Atov in patients with non-HIV PCP.
methodsThe study included patients with non-HIV PCP who were admitted to Fukuoka University Hospital between 2016 and 2023 and initially received SMX/TMP therapy. The primary endpoint was 30-day survival rate from the date of PCP diagnosis. Secondary endpoints included factors associated with mortality and the cumulative incidence of switching from SMX/TMP to Atov.
resultsOf the 56 patients receiving SMX/TMP therapy for PCP, 17 were switched to Atov due to SMX/TMP-related side effects. The Kaplan-Meier estimated 30-day survival was 76.9% in the "remained on" SMX/TMP group and 82.4% in the "switched to" Atov group (log-rank test, P = 0.58). Univariable logistic regression analysis of 30-day mortality showed that switching to Atov was not associated with higher mortality compared with continued SMX/TMP therapy (odds ratio 0.71, 95% confidence interval 0.17 to 3.05). The Kaplan-Meier estimated cumulative incidence of switching from SMX/TMP to Atov during the PCP treatment period was 33.8%.
conclusionOur data suggest that switching from SMX/TMP to Atov may not be associated with worse survival. Long-term administration of SMX/TMP is often challenging due to its side effects, and in this study, more than 30% of patients were unable to tolerate its therapeutic dose. Our findings support the role of Atov as a viable second-line treatment for PCP in immunocompromised patients, such as those with non-HIV PCP.
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