Prophylactic antibiotics

Children and teens on chemotherapy take antibiotics two to three days each week to prevent pneumocystis pneumonia (PCP). They usually continue to take the antibiotics a few months to a year after treatment ends. The antibiotic of choice for PCP prevention is a combination drug containing sulfamethoxazole and trimethoprim; it is sold under the brand names Bactrim and Septra. This antibiotic can cause gastrointestinal upsets, skin rashes, sun sensitivity, and low blood counts. If a substitute is needed, one of the following is used:

• Pentamidine, administered as an aerosol or nebulized (can be difficult for children because it takes 20 minutes to administer and it smells bad), or by IV once a month.

• Dapsone, pills given orally every day.

The oncologist explained it this way. Bactrim is the best prophylactic antibiotic for PCP (pneumocystis), but it can affect counts. Pentamidine IV can affect counts, but nebulizer treatments (once a month) usually don't. Dapsone can be used, but it can cause anemia.

We just started the Dapsone because Katie was starting to buck the nebulizer treatment because it smells and tastes horrible. The Bactrim costs about $3/month, the Dapsone about $7/month, and the Pentamidine nebulizer treatment is about $300/month!

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