[Use of pentamidine nebulization in children].
OBJECTIVE
Pentamidine is a drug generally used for the prophylactic treatment of Pneumocystis pneumonia in immunocompromised patients. The Respirgard II® jet nebulizer has been recommended for pentamidine administration, but this device is no longer available. The aim of our study was to review current clinical practice for pentamidine nebulisation in paediatric hospitals.


METHODS
A survey was sent to the departments of Haematology and Pneumology of university hospitals all over France. We collected information about treatment indications, the number of treated children in 2010, side effects and delivery devices used for nebulization.


RESULTS
Out of the 62 interviewed departments, 36 responses were obtained (58 %). Half the respondents, mostly Haematology departments (n=15/18), used nebulized pentamidine in immunocompromised patients aged 5 to 15 years old who were unable to tolerate sulfamethoxazole-trimethoprim. Sixty-three percent of them treated less than ten children per year, with monthly 150 to 300mg doses administered over a period of 9 to 12 months. Few side effects were reported. In 61 % of the cases, the nebulizer used was unknown or not adapted (1 ultrasonic and 1 mesh nebulizer). In the remaining cases, pentamidine was nebulized with approved jet nebulizers (Isoneb®, Respiromed CR01®, and Microcirrus®).


CONCLUSIONS
Nebulized pentamidine is not used frequently in children. Better information about the appropriateness of nebulizer usage is needed.
Unité de pneumologie pédiatrique et CNRS URMITE 6236, CHU de Timone-Enfants, 264 rue Saint-Pierre, Marseille cedex 05, France.
M
M
Oudyi
J-P
JP
Chaumuzeau
P
P
Diot
J-C
JC
Dubus
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000293:Adolescent; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects; D008954:Models, Biological; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data; D010419:Pentamidine / Q000008:administration & dosage* / Q000009:adverse effects; D045363:Pneumocystis carinii / Q000187:drug effects / Q000502:physiology; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
D000935:Antifungal Agents; D010419:Pentamidine