Prevention of Pneumocystis carinii pneumonia by inhaled pentamidine.
The efficacy and toxicity of pentamidine inhaled once a month to prevent Pneumocystis carinii pneumonia (PCP) was investigated in 102 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC). The cohort was compared with historical controls after a mean duration of prophylaxis of 6.38 months. 86% and 15% of the patients had AIDS or ARC, respectively. 50% of patients had had one previous episode of PCP, 9% had had two episodes, and 3% had had three. 11 patients acquired PCP. Among these 51 patients with one prior episode of PCP, the PCP-free survival after 3.03, 4.7, and 6.38 months of prophylaxis was 98%, 92%, and 82%, respectively. Compared with those for historical controls, the data suggest that inhaled pentamidine can delay relapse by 6 months and reduce the rate of relapse by 50%. PCP acquired while patients were inhaling pentamidine prophylactically was mild and had a case-fatality rate of only 9%. Further investigation of the prophylactic value of inhaled pentamidine is warranted.
Golden
J A
JA
Department of Medicine, School of Medicine, University of California, San Francisco.
Chernoff
D
D
Hollander
H
H
Feigal
D
D
Conte
J E
JE
D000386:AIDS-Related Complex / Q000150:complications; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000280:Administration, Inhalation; D000578:Amidines / Q000008:administration & dosage*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D006801:Humans; D009330:Nebulizers and Vaporizers; D010419:Pentamidine / Q000008:administration & dosage* / Q000627:therapeutic use; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D015215:Zidovudine / Q000627:therapeutic use
D000578:Amidines; D015215:Zidovudine; D010419:Pentamidine