Short Course of Aerosol Pentamidine as Treatment of Pneumocystis carinii Pneumonia in AIDS

Abstract

Since July 1987, 20 HIV-positive patients with Pneumocystis carinii pneumonia (PCP) admitted to the Department of Infectious Diseases, Malmö General Hospital, Sweden have been treated with 10 consecutive days of aerosol pentamidine as sole antimicrobial therapy in a prospective open non-controlled trial. 16 patients (80%) responded to 10 days of 400 mg aerosol pentamidine daily. One patient responded after a prolonged treatment, one patient received simultaneous trimethoprim-sulfamethoxazole due to lack of improvement during aerosol therapy. Two patients died 26 and 41 days after initiation of treatment. No systemic side effects occurred. In conclusion, we found that 10 days of aerosol pentamidine may be a safe and effective treatment of PCP. Controlled studies are needed.

Aerosolized Antimicrobial Therapy in Acutely Ill Patients

“…Early uncontrolled studies of aerosolized pentamidine in patients with mild to moderate PCP administered with a variety of nebulizers often showed similar response rates and better tolerability than systemic therapies (Table 4). 67,68,[71][72][73][74][75][76][77][78][79] However, the importance of using the Respirgard II nebulizer to administer the agent was made apparent in a study that also used Acorn System 22 jet nebulizers. The response rate was dramatically higher in patients treated with the Respirgard II.…”