Chronic pentamidine aerosol prophylaxis does not induce QT prolongation.
Intravenous administration of pentamidine is known to cause long-QT syndrome (Torsade de pointes tachycardias and large QT prolongation) in rare cases and to cause small QT prolongation regularly. A similar pattern is seen with other drugs known to cause a long-QT syndrome. Pentamidine aerosol prophylaxis is commonly used to prevent Pneumocystis carinii pneumonia in HIV-infected persons. The goal of this study was to clarify whether pentamidine aerosol prophylaxis induces QT prolongation. We examined 100 patients receiving pentamidine aerosol prophylaxis at a rather high dose (300 mg biweekly) for at least 1 month (range 1-24) by determining the QT interval corrected for heart rate (QTc), blind for treatment. In a cross-sectional study, QTc was not different in 50 HIV-infected patients with chronic pentamidine aerosol prophylaxis (413 ms), 50 similar HIV-infected patients without pentamidine (407 ms), and 50 similar patients without HIV-infection and without pentamidine (407 ms). In a longitudinal study in another 50 HIV-infected patients, QTc was the same before (414 ms) and on long-term (median 9-month) pentamidine aerosol prophylaxis (414 ms). In contrast to the case with intravenous pentamidine, we found no QT prolongation and thereby no risk of long-QT syndrome with pentamidine aerosol prophylaxis.
Thalhammer
C
C
Medizinische Poliklinik, Universität München.
Bogner
J R
JR
Lohmöller
G
G
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols / Q000494:pharmacology; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology*; D008297:Male; D016555:Matched-Pair Analysis; D010419:Pentamidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D013997:Time Factors; D016276:Ventricular Function / Q000187:drug effects
D000336:Aerosols; D010419:Pentamidine