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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.32 no.4 São Paulo July/Aug. 1990

http://dx.doi.org/10.1590/S0036-46651990000400009 

TREATMENT

 

Aerosolised pentamidine for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome

 

Aerosol de pentamidina no tratamento da pneumonia por Pneumocystis carinii em pacientes com a síndrome da imunodeficiência adquirida

 

 

Adriana WeinbergI,II; Sebastião A. DantonioIII; Maria Irma S. DuarteIV; Wilson L. Pedreira Jr.III; Antonio A. BaroneI; Shinishi IshiokaIII

IDivision of Infectious Diseases of the Hospital das Clínicas of the University of São Paulo School of Medicine. São Paulo, SP, Brazil
IIVirology laboratory of the Instituto de Medicina Tropical, São Paulo, LIM-52. São Paulo, SP, Brazil
IIIDivision of Endoscopy of the Hospital das Clínicas of the University of São Paulo School of Medicine. São Paulo, SP, Brazil
IVDepartment of Pathology of the University of São Paulo School of Medicine. São Paulo, SP, Brazil

Address for correspondence

 

 


SUMMARY

The goal of this study was to evaluate inhaled pentamidine for the treatment of patients with mild and moderate Pneumocystis carinii pneumonitis. Eight adults with AIDS and pneumocystis pneumonia (4 with a first episode and 4 with a repeat pneumocystosis) received daily inhalations of aerosol pentamidine isethionate for 21 days. Six patients were treated with doses of 300 mg of pentamidine and the remaining 2 received 600 mg every day. In the 300 mg treatment group, 2 individuals showed discrete and transient neutropenia. However, both subjects that received 600 mg of aerosol pentamidine daily developed leukopenia. One of them had major toxicity (overall severe intolerance of 12.5%) that required drug discontinuation and did not allow any analysis of the treatment efficacy. Of the 7 evaluable patients, 6 (88%) completed the treatment successfuly. One subject of the 300 mg regimen experienced an early recurrence. In conclusion, inhaled pentamidine is an effective treatment for mild and moderate cases of P. carinii pneumonia. It is less toxic than standard anti-pneumocystis therapy and is suitable for outpatient use.

Key words: Acquired immunodeficiency syndrome; Pneumocystis carinii pneumonia; Pentamidine; Inhalatory therapy.


RESUMO

O objetivo deste estudo consistiu em avaliar pentamidina inalatória para o tratamento de pneumonia leve a moderada, causada por Pneumocystis carinii. Oito adultos com a síndrome da imunodeficiência humana e pneumocistose (4 apresentando o primeiro episódio e 4 na vigência de pneumocistose de repetição) receberam inalações diárias de isetionato de pentamidina por 21 dias. Seis pacientes foram tratados com doses de 300 mg de pentamidina e os 2 restantes receberam 600 mg diariamente. No grupo de 300 mg, 2 indivíduos desenvolveram neutropenia leve e transitória. Porém, ambos os pacientes recebendo 600 mg de pentamidina aerosol apresentaram leucopenia. Um deles teve toxicidade importante (intolerância global de 12,5%), que levou a suspensão da droga e impediu a avaliação da sua eficácia. Entre os 7 pacientes que puderam ser avaliados, 6 (86%) completaram o tratamento com sucesso. Um paciente que recebeu 300 mg de pentamidina diariamente teve uma recorrência precoce. Em conclusão, a pentamidina inalatória representa uma modalidade terapêutica eficaz contra a pneumonia por Pneumocystis carinii. E menos tóxica do que as drogas usadas convencionalmente e também pode ser administrada ambulatorialmente.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

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Address for correspondence:
A. Weinberg
Av. Dr. Enéas C. Aguiar, 470
05403 S. Paulo, Brasil

Recebido para publicação em 13/10/1989.
This work was supported by a grant from Rhodia Farma Ltda.

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