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  • Title: Prophylaxis of Pneumocystis carinii pneumonia with atovaquone in children with leukemia.
    Author: Madden RM, Pui CH, Hughes WT, Flynn PM, Leung W.
    Journal: Cancer; 2007 Apr 15; 109(8):1654-8. PubMed ID: 17345613.
    Abstract:
    BACKGROUND: Despite extensive studies of atovaquone in human immunodeficiency virus (HIV)-infected patients, there is little information about its efficacy as a prophylactic agent for Pneumocystis carinii pneumonia (PCP) in pediatric patients with cancer. Therefore, a retrospective analysis was conducted to determine the incidence of PCP in pediatric patients who received prophylactic atovaquone during treatment for acute leukemia. METHODS: We reviewed the medical records of all patients treated at our institution for acute lymphoblastic leukemia or acute myeloid leukemia between 1994 and 2004. Only patients who were intolerant of trimethoprim-sulfamethoxazole (TMP-SMZ) and received atovaquone prophylaxis were included in the analysis. RESULTS: Eighty-six patients were unable to tolerate TMP-SMZ and received daily atovaquone for PCP prophylaxis. PCP was not diagnosed in any patient who received atovaquone prophylaxis: the upper limit of the 95% confidence interval (CI) was 1.74 per 100 person-years. CONCLUSIONS: Atovaquone is an efficacious alternative for PCP prophylaxis in pediatric patients who have leukemia and are intolerant of TMP-SMZ.
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