Sulfamethoxazole / Trimethoprim confer no change on the clinical course of Kawasaki disease
Kawasaki disease (KD) is one of the most common vasculitis in childhood, but its etiology is still unknown. We hypothesized that Sulfamethoxazole / Trimethoprim (S/T) would inhibit overproduction of cytokine due to heat shock protein produced by intestinal bacteria in patients with KD and improve the clinical course of KD indirectly. We have conducted a prospective study to assess the usefulness of S/T for KD. For patients with KD (S/T group, N=23), we use S/T in addition to the standard treatment in the guidelines such as intravenous immunoglobulin (IVIG) and moderate dose aspirin. The control group (non S/T group, N=32) is patients with KD treated with the standard treatment in the guidelines. The baseline characteristics did not demonstrate notable differences between the two groups. We compare duration of fever, rate of initial IVIG failure, the day of illness membranous desquamation appeared, and the occurrence of coronary artery lesion (CAL) between two groups. Membranous desquamation appeared rather earlier in S/T group than in non S/T group (11.4±3.0 day of illness vs 12.9±3.5 day of illness, P=0.078), but there was no statistically significant difference. Duration of fever (39±59 hours vs 42±57 hours, P=0.41), rate of initial IVIG failure (26% vs 31%, P=0.30), and number of CAL (8.6% vs 9.3%, P=0.87) were found no significant difference between two groups. These data indicated that the use of S/T in acute phase of KD didn’t improve any clinical course of KD. doi：10.11482/KMJ-E40（2）65 (Accepted on June 12, 2014)
