0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Inhaled or Intravenous Pentamidine Therapy for Pneumocystis carinii Pneumonia in AIDS: A Randomized Trial

Guy W. Soo Hoo, MD, MPH; Zab Mohsenifar, MD; and Richard D. Meyer, MD
[+] Article and Author Information

Grant Support: In part by a grant from LyphoMed, Inc., Rosemont, Illinois.

Requests for Reprints: Guy W. Soo Hoo, MD, Pulmonary and Critical Care Section, Wadsworth Veterans Affairs Medical Center (W111B), Wilshire and Sawtelle Boulevards, Los Angeles, CA, 90073.

Current Author Addresses: Dr. Soo Hoo: Pulmonary and Critical Care Section, Wadsworth Veterans Affairs Medical Center (W111B), Wilshire and Sawtelle Boulevards, Los Angeles, CA 90073.

Dr. Mohsenifar: Division of Pulmonary Diseases and Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048.

Dr. Meyer: Division of Infectious Diseases and Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048.


© 1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;113(3):195-202. doi:10.7326/0003-4819-113-3-195
Text Size: A A A

Objective: To compare inhaled pentamidine with intravenous pentamidine for the treatment of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (AIDS).

Design: A randomized trial.

Setting: Community teaching hospital and hospital-based outpatient treatment center.

Patients: Twenty-one homosexual men with Pneumocystis pneumonia; 11 received inhaled pentamidine and 10 received intravenous pentamidine.

Intervention: Inhaled (8 mg/kg body weight) or intravenous (4 mg/kg body weight) pentamidine administered daily for 21 days.

Measurements and Main Results: All patients responded to intravenous pentamidine, whereas 6 of 11 (55%; 95% CI, 23% to 83%; P = 0.02, Fisher exact test) responded to inhaled pentamidine therapy. Two patients who failed inhaled pentamidine therapy eventually died despite appropriate intravenous therapy (mortality rate, 18%; CI, -6% to 42%). Nonresponders to inhaled pentamidine had a greater severity of illness compared with responders to this therapy, as shown by a lower mean (± SE) PaO2 (8.0 ± 0.4 kPa compared with 10.8 ± 0.6 kPa; P = 0.005) and higher alveolararterial PO2 difference (6.8 ± 0.6 kPa compared with 2.8 ± 0.8 kPa; P = 0.003).

Conclusions: Inhaled pentamidine is probably as effective as intravenous pentamidine in patients with mild Pneumocystis pneumonia. However, its use as sole therapy in patients with moderate to severe Pneumocystis pneumonia is not supported by the results of our study and is not warranted.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)