[Prevention of Pneumocystis carinii pneumonia associated with HIV infection using pentamidine aerosols. Retrospective study of 465 cases].
OBJECTIVE
At least 80% of human immunodeficiency virus (HIV)-positive patients not given prophylaxis therapy against Pneumocystis carinii develop pneumonia, a major cause of morbidity and mortality. We therefore retrospectively evaluated prophylaxis protocols given from March 1988 to July 1991 at the Pasteur Institute Hospital.


METHODS
Pentamidine aerosols were prescribed for 456 HIV-positive patients as primary or secondary prophylaxis. From March 1988 to November 1989 the dose was 4 mg/kg pentamidine mesylate once a month for primary prophylaxis and 4 mg/kg twice a month for secondary prophylaxis. From November 1989 pentamidine isethionate was given at the dose of 300 mg once a month.


RESULTS
Tolerance was generally good, treatment had to be discontinued in only 2 of the 456 patients due to side effects. Pneumocystis carinii pneumonia was diagnosed in 4.9% of the treated patients, but in only 2.9% of those who were compliant. Pneumocystis carinii pneumonia occurred in very immunodepressed patients and radiologically appeared as an interstitial or alveolo-interstitial syndrome, often with a macronodular element, in 65% of the patients.


CONCLUSIONS
The results of this retrospective study confirm the prophylactic value of pentamidine aerosols given after trimethoprim-sulfamethoxasol.
Guinet
F
F
Service des Maladies infectieuses et tropicales, Hôpital de l'Institut Pasteur et CHU Necker-Enfants Malades, Paris.
Pialoux
G
G
Trotot
P
P
Chauvelle
M T
MT
Feuillie
V
V
Sansonetti
P
P
Dupont
B
B
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000328:Adult; D000336:Aerosols; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010419:Pentamidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000336:Aerosols; D010419:Pentamidine
Prophylaxie de la pneumocystose pulmonaire associée à l'infection VIH par aérosols de pentamidine. Etude rétrospective de 465 cas.