Trimethoprim-Sulfamethoxazole or Pentamidine for Pneumocystis carinii Pneumonia
Authors: PAUL BÉGIN
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 March 1987Trimethoprim-Sulfamethoxazole or Pentamidine for Pneumocystis carinii PneumoniaPAUL BÉGIN, M.D., JAMES HANLEY, Ph.D.PAUL BÉGIN, M.D.Search for more papers by this author, JAMES HANLEY, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-3-474_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their report on the treatment of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (AIDS), Wharton and colleagues (1) conclude, "We have shown that trimethoprim-sulfamethoxazole and pentamidine isethionate are probably of equal effectiveness." Is this conclusion consistent with their own statistical analysis?Their point estimate of the short-term mortality for patients on trimethoprim-sulfamethoxazole therapy was 25% (5 of 20 patients) but only 5% for patients on pentamidine therapy (1 of 20). Using the binomial distribution, they provide a 95% confidence interval of 1% to 39% for this 20% difference in short-term mortality rates. Because the interval...References1. WHARTONCOLEMANWOFSY JDC. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome: a prospective randomized trial. Ann Intern Med. 1986;105:37-44. LinkGoogle Scholar2. DETSKYSACKETT AD. When was a 'negative' clinical trial big enough?: how many patients you needed depends on what you found. Arch Intern Med. 1985;145:709-12. CrossrefMedlineGoogle Scholar3. MURRAYFELTONGARAY JCS. Pulmonary complications of the acquired immunodeficiency syndrome: report of a National Heart, Lung and Blood Institute worship. N Engl J Med. 1984;310:1682-8. CrossrefMedlineGoogle Scholar4. HUGHESFELDMANCHAUDHARYOSSICOXSANYAL WSSMFS. Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia. J Pediatr. 1978;92:285-91. CrossrefMedlineGoogle Scholar5. SIEGALWOLFFBAEHNERHAMMOND SLRD. Treatment of Pneumocystis carinii pneumonitis: a comparative trial of sulfamethoxazole-trimethoprim versus pentamidine in pediatric patients with cancer: report from the Children's Cancer Study. Am J Dis Child. 1984;138:1051-4. CrossrefMedlineGoogle Scholar1. WHARTONCOLEMANWOFSY JDC. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome: a prospective randomized trial. Ann Intern Med. 1986;105:37-44. LinkGoogle Scholar2. ARMITAGE P. Statistical Methods in Medical Research. New York: J. Wiley & Sons; 1971:135-8. Google Scholar3. SALSBURG D. The religion of statistics as practiced in medical journals. Am Stat. 1985;39:220-3. Google Scholar4. FREIMANCHALMERSSMITHKUEBLER JTHR. The importance of beta, the type II error and sample size in the design and interpretation of the randomized clinical trial: survey of 71 "negative" trials. N Engl J Med. 1978;299:690-4. CrossrefMedlineGoogle Scholar5. MAKUCHJOHNSON RM. Some issues in the design and interpretation of 'negative' clinical studies. Arch Intern Med. 1986;146:986-9. CrossrefMedlineGoogle Scholar1. WHARTONCOLEMANWOLFSY JDC. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Ann Intern Med. 1986;105:37-44. LinkGoogle Scholar1. DENNIS T. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome [Letter]. Ann Intern Med. 1986;105:629-30. LinkGoogle Scholar2. MARANTZ P. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome [Letter]. Ann In tern Med. 1986;105:630. Google Scholar3. HUGHESFELDMANCHAUDHARYOSSICOXSANYAL WSSMFS. Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia. J Pediatr. 1978;92:285-91. CrossrefMedlineGoogle Scholar4. SIEGALWOLFFBAEHNERHAMMOND SLRD. Treatment of Pneumocystis carinii pneumonitis: a comparative trial of sulfamethoxazole-trimethoprim versus pentamidine in pediatric patients with cancer: report from the Children's Cancer Study. Am J Dis Child. 1984;138:1051-4. CrossrefMedlineGoogle Scholar5. KLEINDUNCANSONLENOX MFT. Prospective randomized treatment for Pneumocystis carinii pneumonia (PCP) in AIDS patients [Poster 293]. In: Proceedings of the Second International Conference on AIDS, June 1986. Paris: International Conference on AIDS; 1986:52. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Hôpital Notre-Dame, l'Université de Montréal Montréal, Québec H2L 4Ml Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited by4 Active Control Equivalence StudiesIssues in planning and interpreting active control equivalence studiesManagement of Pneumocystis carinii Pneumonia in Patients with AIDS and Other Conditions: Experience in a Philadelphia University Teaching Hospital 1 March 1987Volume 106, Issue 3Page: 474-476KeywordsAIDSConfidence intervalsDeath ratesMortalityPneumocystis carinii pneumonia Issue Published: 1 March 1987 PDF downloadLoading ...