Int Conf AIDS. 1992 Jul 19-24;8(3):51 (abstract no. PuB 7015). Unique
OBJECTIVE: To evaluate the efficacy and safety of aerosolized
pentamidine (AP) for primary (PP) and secondary prophylaxis (SP) against
Pneumocystis carinii pneumonia (PCP) in patients at risk for PCP.
METHODS: From July 1990 to December 1991, 79 patients at risk for PCP
because of prior PCP (SP) or a CD4+ cell count below 200/mmc (PP)
entered into this study. A dose of 300 mg of pentamidine isethionate was
administered every four weeks through a Respirgard II jet nebulizer.
Inhaled salbutamol (2 puffs) was given to all patients before AP.
Zidovudine and didanosine were concurrently used in 62 and 8 patients,
respectively. RESULTS: SP was performed in 18 patients. Twenty-nine AIDS
patients without a previous PCP and 32 subjects with a CD4+ cell count
below 200/mmc received PP. At the moment, median duration of AP
prophylaxis is 9 months (range 2-20). There were 3 (16.7%) relapses of
PCP. Two cases of PCP occurred among patients receiving PP, although 72%
of them were at high risk of PCP (CD4+ count cell below 100/mmc and/or
oral thrush). Seven patients died, of them 2 had a recurrent PCP. Three
subjects were lost to follow-up. There were no serious adverse reactions
and no systemic toxicity was seen. CONCLUSIONS: Aerosolized pentamidine
is safe and effective, even in patients at high risk for PCP.
Acquired Immunodeficiency Syndrome/*COMPLICATIONS Aerosols Human
Pentamidine/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Pneumonia,
Pneumocystis carinii/COMPLICATIONS/*PREVENTION & CONTROL Risk Factors