[Pentamidine inhalation in prevention of pneumocystis carinii pneumonia in treatment of rejection with monoclonal antibody Orthoclone (OKT-3)].
The use of the monoclonal antibody OKT-3 (Orthoclone) is associated with an increased risk of pneumocystis carinii pneumonia. In a retrospective study, the efficiency of a prophylactic inhalation of pentamidine during acute renal allograft rejection therapy with OKT-3 was investigated. From July 1988 until October 1989 32 renal transplanted patients with acute rejection refractory to steroids had been treated with OKT-3. Twelve of the patients developed a pneumonia (four pneumococcus, one klebsiella, one cytomegalovirus), in six cases, a pneumocystis carinii infection was diagnosed in the bronchial lavage. Four of these patients with pneumocystis carinii pneumonia died despite high dose treatment with cotrimoxazole. From November 1989, a prophylactic inhalation of pentamidine was performed during acute renal allograft rejection therapy with OKT-3. From 33 patients, in eleven cases, a pneumonia was diagnosed (three pneumococcus, one klebsiella, two legionella, three cytomegalovirus, one candida), one patient developed a pneumocystis carinii pneumonia, which was successfully treated with cotrimoxazole. No patient in this group died because of pulmonary infection. The results suggest, that a prophylactic inhalation of pentamidine in severely immunosuppressed solid organ transplant recipients can prevent pneumocystis carinii pneumonia.
Barenbrock
M
M
Medizinische Poliklinik, Westfälischen Wilhelms-Universität, Münster.
Spieker
C
C
Buchholz
B
B
Zidek
W
W
Rahn
K H
KH
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000009:adverse effects* / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000276:immunology / Q000517:prevention & control*; D010419:Pentamidine / Q000008:administration & dosage*; D011020:Pneumonia, Pneumocystis / Q000276:immunology / Q000517:prevention & control*; D012189:Retrospective Studies
D016853:Muromonab-CD3; D010419:Pentamidine
Die Pentamidin-Inhalation als Prophylaxe der Pneumocystis-carinii-Pneumonie bei der Rejektionsbehandlung mit monoklonalem Antikörper Orthoclone (OKT-3).