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Effect of aerosolized pentamidine prophylaxis on the clinical severity and diagnosis of Pneumocystis carinii pneumonia.
Am Rev Respir Dis. 1992 Oct; 146(4):844-8.AR

Abstract

To determine if the use of aerosolized pentamidine prophylaxis decreases the clinical severity or the sensitivity of diagnostic tests for Pneumocystis carinii pneumonia (PCP), we conducted a retrospective matched cohort comparison study of patients admitted to San Francisco General Hospital with PCP from August 1, 1989, to June 30, 1990. Patients who had received pentamidine prophylaxis during at least the 2 months prior to the diagnosis of PCP were matched with patients who had not received the drug. Matching was based on the number of prior episodes of PCP, sex, age, and risk factors for human immunodeficiency virus infection. As markers of clinical severity, we chose alveolar-arterial oxygen difference, serum lactate dehydrogenase levels, outpatient versus inpatient treatment, length of hospitalization, length of intravenous anti-pneumocystis treatment, development of respiratory failure, in-hospital mortality, and chest radiographic appearance. Although, of the 27 matched pairs identified, significantly fewer of the pentamidine cohort were treated as inpatients, and significantly more of this cohort had upper lobe dominant disease on chest radiograph, we found no other significant differences between markers of clinical severity for the two cohorts. In addition, we found no significant differences in the rate of sputum or bronchoalveolar lavage positivity for P. carinii between the two cohorts. We conclude that, although hospitalization is less common in patients with a history of prophylactic pentamidine use, aerosolized pentamidine prophylaxis does not decrease the clinical severity or the sensitivities of sputum induction or bronchoalveolar lavage as diagnostic tests for PCP.

Authors+Show Affiliations

Fahy JV
San Francisco General Hospital Medical Center, California.
Chin DP
No affiliation info available
Schnapp LM
No affiliation info available
Steiger DJ
No affiliation info available
Schaumberg TH
No affiliation info available
Geaghan SM
No affiliation info available
Klein JS
No affiliation info available
Hopewell PC
No affiliation info available

MeSH

AIDS-Related Opportunistic InfectionsAdministration, InhalationAdultAerosolsCohort StudiesFemaleHumansMalePentamidinePneumonia, PneumocystisRetrospective StudiesRisk FactorsSensitivity and Specificity

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1416408

Citation

Fahy, J V., et al. "Effect of Aerosolized Pentamidine Prophylaxis On the Clinical Severity and Diagnosis of Pneumocystis Carinii Pneumonia." The American Review of Respiratory Disease, vol. 146, no. 4, 1992, pp. 844-8.
Fahy JV, Chin DP, Schnapp LM, et al. Effect of aerosolized pentamidine prophylaxis on the clinical severity and diagnosis of Pneumocystis carinii pneumonia. Am Rev Respir Dis. 1992;146(4):844-8.
Fahy, J. V., Chin, D. P., Schnapp, L. M., Steiger, D. J., Schaumberg, T. H., Geaghan, S. M., Klein, J. S., & Hopewell, P. C. (1992). Effect of aerosolized pentamidine prophylaxis on the clinical severity and diagnosis of Pneumocystis carinii pneumonia. The American Review of Respiratory Disease, 146(4), 844-8.
Fahy JV, et al. Effect of Aerosolized Pentamidine Prophylaxis On the Clinical Severity and Diagnosis of Pneumocystis Carinii Pneumonia. Am Rev Respir Dis. 1992;146(4):844-8. PubMed PMID: 1416408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of aerosolized pentamidine prophylaxis on the clinical severity and diagnosis of Pneumocystis carinii pneumonia. AU - Fahy,J V, AU - Chin,D P, AU - Schnapp,L M, AU - Steiger,D J, AU - Schaumberg,T H, AU - Geaghan,S M, AU - Klein,J S, AU - Hopewell,P C, PY - 1992/10/1/pubmed PY - 1992/10/1/medline PY - 1992/10/1/entrez SP - 844 EP - 8 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 146 IS - 4 N2 - To determine if the use of aerosolized pentamidine prophylaxis decreases the clinical severity or the sensitivity of diagnostic tests for Pneumocystis carinii pneumonia (PCP), we conducted a retrospective matched cohort comparison study of patients admitted to San Francisco General Hospital with PCP from August 1, 1989, to June 30, 1990. Patients who had received pentamidine prophylaxis during at least the 2 months prior to the diagnosis of PCP were matched with patients who had not received the drug. Matching was based on the number of prior episodes of PCP, sex, age, and risk factors for human immunodeficiency virus infection. As markers of clinical severity, we chose alveolar-arterial oxygen difference, serum lactate dehydrogenase levels, outpatient versus inpatient treatment, length of hospitalization, length of intravenous anti-pneumocystis treatment, development of respiratory failure, in-hospital mortality, and chest radiographic appearance. Although, of the 27 matched pairs identified, significantly fewer of the pentamidine cohort were treated as inpatients, and significantly more of this cohort had upper lobe dominant disease on chest radiograph, we found no other significant differences between markers of clinical severity for the two cohorts. In addition, we found no significant differences in the rate of sputum or bronchoalveolar lavage positivity for P. carinii between the two cohorts. We conclude that, although hospitalization is less common in patients with a history of prophylactic pentamidine use, aerosolized pentamidine prophylaxis does not decrease the clinical severity or the sensitivities of sputum induction or bronchoalveolar lavage as diagnostic tests for PCP. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/1416408/Effect_of_aerosolized_pentamidine_prophylaxis_on_the_clinical_severity_and_diagnosis_of_Pneumocystis_carinii_pneumonia_ DB - PRIME DP - Unbound Medicine ER -
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