DAPSONE PENETRATES CEREBROSPINAL-FLUID DURING PNEUMOCYSTIS-CARINII PNEUMONIA PROPHYLAXIS

Dapsone has been proposed as a prophylactic agent for both Pneumocysti s carinii pneumonia (PCP) and reactivation cerebral toxoplasmosis. To determine whether dapsone penetrates the central nervous system, cereb rospinal fluid (CSF) and serum samples were drawn from patients taking dapsone for PCP prophylaxis. These samples were quantitatively assaye d using high-performance liquid chromatography. Five AIDS patients and one cardiac transplant patient had CSF assayed for dapsone. Only one had evidence of CSF inflammation, resulting from a paraspinal abscess. Doses ranged from 50 mg 3 days/week to 100 mg/day, and levels were 0. 30-1.61 mu g/ml, which are in the range of inhibition of Toxoplasma go ndii tachyzoites. This is the first report to demonstrate that dapsone enters the CSF, land supports preliminary clinical evidence that daps one may have protective activity against cerebral toxoplasmosis when u sed for PCP prophylaxis.