Septrin

[Jsk1950]

Found a Brian deer investion into Septrin from the times newspaper in the U.K.

Don’t know what year it was

Unbelievable reading is it still prescribed to our Aussie and American readers ?

[Oleboyredw-uk]

Hi Jsk1950,

Perhaps you could share a link to the report and the title please?

Co-trimoxizole (or Seotrin) is used in the UK and other countries as well. I’ve just been on if for about eight months.

rob

[AussieNeil Partner Administrator]

It all comes down to risk vs reward. One of the conditions it is recommended for is "a type of pneumonia called PCP, which is caused by the bacterium Pneumocystis jirovecii, previously known as Pneumocystis carinii." That infection can be fatal and patients on some CLL treatments are at considerable risk of developing PCP:

netdoctor.co.uk/medicines/i...

Hence the use of septrim/bactrrim (septra in USA) as a prophylactic.

Neil

[Senecio in reply to AussieNeil]

I believe Pneumocystis is a fungus rather than a bacterium:

cdc.gov/fungal/diseases/pne...

This is one of those rare examples where an anti-bacterial antibiotic has some efficacy against a fungus infection.

John

[AussieNeil Partner Administrator in reply to Senecio]

Netdoctor needs correction! Drugs.com wisely doesn't state what Pneumocystis is

drugs.com/septra.html

[Jsk1950]

Https://Briandeer.com>septrin3

Sunday times March 20 1994

[Senecio]

Now I've read the article it does make the point (as a throwaway comment) that the sulphur element of the drug does have application in AIDS and some other unusual illnesses. So that is why it is used in CLL treatments to prevent pneumocystis infection (which I imagine is extremely difficult to treat like other fungal lung infections). I was prescribed it as co-trimoxazole, and it turned out that I was allergic to it - I had initially a rash (considered to be caused by allopurinol, which it could have been), but then a very high temperature, which led to my admission to hospital. I stopped the co-trimoxazole and the temperature returned to normal. However, it is worth noting that my team prescribed dapsone as an alternative. It is another sulphur based drug originally used as an anti leprosy treatment. It also has unpleasant side-effects and to say that my body tolerated it is perhaps to put it a bit strongly. My urine was mostly brownish, and the oxygen levels of my blood as measured by the clip-on devices was significantly reduced. My suspicion was that it caused methemoglobulinemia and further damaged my haemoglobin/red cell count. So the question is, do doctors continue to use co-trimoxazole (while keeping an eye on potential side effects), replace it with a drug which is probably rather inferior (dapsone), or risk infection with Pneumocystis pneumonia?

John

[Senecio in reply to Senecio]

Sorry, meant to add this link to Wikipedia's comments on dapsone:

en.wikipedia.org/wiki/Dapsone

John

[Jm954 Administrator in reply to Senecio]

It's well known that Dapsone causes haemolysis

[Senecio in reply to Jm954]

Indeed. When Wikipedia list the adverse effects in the contents page, you know they are significant!

John

[Cllcanada Top Poster CURE Hero]

I was on cotrimoxazole for about 18 months. Its a required prophylactic for Zydelig (idelalisib). I was monitored monthly.

medlineplus.gov/druginfo/me...

Unfortunately an invasive episode of aspergillus ended all that...

~chris

[Graham2222]

I was on co-trimoxazole in the UK for four months until a severe rash and itch, which has not yet gone entirely, put a stop to that. I’m now on pentamadene by nebuliser once a month as an alternative.