Utility of inhaled pentamidine prophylaxis in lung transplant recipients.
The incidence of Pneumocystis carinii pneumonia (PCP) has been shown to be high posttransplantation in the absence of prophylaxis. For this reason, lung transplant recipients routinely receive prophylaxis. We report on our results using aerosolized pentamidine prophylaxis in nine patients post-lung transplantation (eight single lung transplants, one double). The patients received monthly treatments of 300 mg of aerosolized pentamidine for a mean of 10.6 months (range, 4 to 21 months). Patients were routinely monitored with serial pulmonary function studies and bronchoscopy as clinically indicated. Two of the patients experienced bronchospasm in response to the therapy. None of the patients experienced any episodes of PCP during the period of inhaled pentamidine prophylaxis. Inhaled pentamidine is a safe and effective form of PCP prophylaxis and may be used instead of sulfamethoxazole-trimethoprim in patients who have a sulfa allergy or other untoward sulfa side effects.
Nathan
S D
SD
Cedars-Sinai Medical Center, Department of Medicine, Los Angeles 90048.
Ross
D J
DJ
Zakowski
P
P
Kass
R M
RM
Koerner
S K
SK
D000280:Administration, Inhalation; D000336:Aerosols; D001986:Bronchial Spasm / Q000139:chemically induced; D001999:Bronchoscopy; D004342:Drug Hypersensitivity; D005541:Forced Expiratory Volume / Q000187:drug effects; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation / Q000009:adverse effects; D008450:Maximal Midexpiratory Flow Rate / Q000187:drug effects; D009330:Nebulizers and Vaporizers; D010419:Pentamidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D012189:Retrospective Studies; D013147:Spirometry; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects; D014797:Vital Capacity / Q000187:drug effects
D000336:Aerosols; D007166:Immunosuppressive Agents; D010419:Pentamidine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination