The medication for pneumocystis pneumonia with glucose-6-phosphate dehydrogenase deficiency patients

Ziyu Zhang; Qinhui Li; Xiaoyan Shen; Lankai Liao; Xia Wang; Min Song; Xi Zheng; Yulian Zhu; Yong Yang

doi:10.3389/fphar.2022.957376

The medication for pneumocystis pneumonia with glucose-6-phosphate dehydrogenase deficiency patients

Front Pharmacol. 2022 Sep 7:13:957376. doi: 10.3389/fphar.2022.957376. eCollection 2022.

Authors

Ziyu Zhang^{1

2}, Qinhui Li³, Xiaoyan Shen⁴, Lankai Liao⁵, Xia Wang¹, Min Song¹, Xi Zheng², Yulian Zhu⁶, Yong Yang^{2

7}

Affiliations

¹ Department of Pharmacy, The First People's Hospital of Ziyang, Ziyang, China.
² Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
³ Department of Medical, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
⁴ Department of Pharmacy, Chengdu Qingbaijiang District People's Hospital, Chengdu, China.
⁵ Intensive Care Unit, The Third Hospital of Mianyang, Mianyang, China.
⁶ Department of Pharmacy, Ziyang People's Hospital, Ziyang, China.
⁷ Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Abstract

Pneumocystis pneumonia (PCP) is an opportunity acquired infection, which is usually easy to occur in patients with AIDS, organ transplantation, and immunosuppressive drugs. The prevention and treatment must be necessary for PCP patients with immunocompromise. And the oxidants are currently a typical regimen, including sulfanilamide, dapsone, primaquine, etc. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked gene-disease that affects about 400 million people worldwide. The lack of G6PD in this population results in a decrease in intracellular glutathione synthesis and a weakening of the detoxification ability of the oxidants. As a result, oxidants can directly damage haemoglobin in red blood cells, inducing methemoglobin and hemolysis. When patients with G6PD deficiency have low immunity, they are prone to PCP infection, so choosing drugs that do not induce hemolysis is essential. There are no clear guidelines to recommend the drug choice of this kind of population at home and abroad. This paper aims to demonstrate the drug choice for PCP patients with G6PD deficiency through theoretical research combined with clinical cases.

Keywords: G6PD; PCP; hemolysis; immunocompromise; oxidant.

Publication types

Review