Atovaquone Compared with Dapsone for the Prevention of Pneumocystis carinii Pneumonia in Patients with HIV Infection Who Cannot Tolerate Trimethoprim, Sulfonamides, or Both

The prevention of Pneumocystis carinii pneumonia has had a substantial influence on the course of human immunodeficiency virus (HIV) disease. 1 , 2 Although trimethoprim–sulfamethoxazole is the treatment of choice for prophylaxis against P. carinii pneumonia, intolerance often limits its use and makes it necessary to use alternative regimens. 3 Dapsone, alone or in combination with pyrimethamine, is a commonly recommended prophylactic regimen for P. carinii pneumonia in patients who cannot tolerate trimethoprim–sulfamethoxazole. 4 Dapsone plus pyrimethamine has been shown to be superior to aerosolized pentamidine for the prevention of toxoplasmosis. 5 However, dapsone has limitations: it is less effective than trimethoprim–sulfamethoxazole for the prevention . . .