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Effect of aerosolized pentamidine prophylaxis on the diagnosis of Pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus.
Am Rev Respir Dis. 1991 Oct; 144(4):760-4.AR

Abstract

This study assessed the effect of aerosolized pentamidine prophylaxis on the clinical presentation and diagnostic sensitivity of induced sputum examination for Pneumocystis carinii pneumonia. Between January 1, 1988 and October 27, 1990, 348 induced sputum examinations were performed as the initial diagnostic procedure for P. carinii pneumonia in patients infected with the human immunodeficiency virus (HIV). Medical records were reviewed for all induced sputum examinations, and the study group consisted of patients who either had not received prophylactic therapy (n = 193) or had received aerosolized pentamidine prophylaxis (n = 126). A total of 29 induced sputum examinations in patients receiving either other prophylactic regimens or ongoing therapy for previously documented P. carinii pneumonia were excluded from the study group. A total of 72 consecutive episodes of P. carinii pneumonia were subsequently documented by induced sputum examination (n = 54), bronchoalveolar lavage (n = 16), thoracocentesis (n = 1), or autopsy (n = 1). A total of 44 episodes occurred in patients who had not received antipneumocystis prophylaxis, and 28 episodes occurred in patients who had received aerosolized pentamidine. Of patients capable of producing a sputum specimen for analysis, induced sputum examination had a significantly lower diagnostic yield of 64.3% in patients who had received aerosolized pentamidine prophylaxis compared with 92.3% in patients who did not receive prophylaxis (p less than 0.02, Fisher's exact test). When the data were analyzed on an intention to treat basis, although there was a trend suggesting a lower overall yield in the aerosolized pentamidine patients, the difference was not statistically significant (64.3 versus 81.8%, p = 0.17, Fisher's exact test).(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Levine SJ
Critical Care Medicine, Microbiology Department, Warren G. Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD.
Masur H
No affiliation info available
Gill VJ
No affiliation info available
Feuerstein I
No affiliation info available
Suffredini AF
No affiliation info available
Brown D
No affiliation info available
Lane HC
No affiliation info available
Yarchoan R
No affiliation info available
Shelhamer JH
No affiliation info available
Ognibene FP
No affiliation info available

MeSH

AerosolsBronchoalveolar Lavage FluidHIV InfectionsHIV-1HumansLungPentamidinePneumocystisPneumonia, PneumocystisRadiographySputum

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1928945

Citation

Levine, S J., et al. "Effect of Aerosolized Pentamidine Prophylaxis On the Diagnosis of Pneumocystis Carinii Pneumonia By Induced Sputum Examination in Patients Infected With the Human Immunodeficiency Virus." The American Review of Respiratory Disease, vol. 144, no. 4, 1991, pp. 760-4.
Levine SJ, Masur H, Gill VJ, et al. Effect of aerosolized pentamidine prophylaxis on the diagnosis of Pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus. Am Rev Respir Dis. 1991;144(4):760-4.
Levine, S. J., Masur, H., Gill, V. J., Feuerstein, I., Suffredini, A. F., Brown, D., Lane, H. C., Yarchoan, R., Shelhamer, J. H., & Ognibene, F. P. (1991). Effect of aerosolized pentamidine prophylaxis on the diagnosis of Pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus. The American Review of Respiratory Disease, 144(4), 760-4.
Levine SJ, et al. Effect of Aerosolized Pentamidine Prophylaxis On the Diagnosis of Pneumocystis Carinii Pneumonia By Induced Sputum Examination in Patients Infected With the Human Immunodeficiency Virus. Am Rev Respir Dis. 1991;144(4):760-4. PubMed PMID: 1928945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of aerosolized pentamidine prophylaxis on the diagnosis of Pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus. AU - Levine,S J, AU - Masur,H, AU - Gill,V J, AU - Feuerstein,I, AU - Suffredini,A F, AU - Brown,D, AU - Lane,H C, AU - Yarchoan,R, AU - Shelhamer,J H, AU - Ognibene,F P, PY - 1991/10/1/pubmed PY - 1991/10/1/medline PY - 1991/10/1/entrez SP - 760 EP - 4 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 144 IS - 4 N2 - This study assessed the effect of aerosolized pentamidine prophylaxis on the clinical presentation and diagnostic sensitivity of induced sputum examination for Pneumocystis carinii pneumonia. Between January 1, 1988 and October 27, 1990, 348 induced sputum examinations were performed as the initial diagnostic procedure for P. carinii pneumonia in patients infected with the human immunodeficiency virus (HIV). Medical records were reviewed for all induced sputum examinations, and the study group consisted of patients who either had not received prophylactic therapy (n = 193) or had received aerosolized pentamidine prophylaxis (n = 126). A total of 29 induced sputum examinations in patients receiving either other prophylactic regimens or ongoing therapy for previously documented P. carinii pneumonia were excluded from the study group. A total of 72 consecutive episodes of P. carinii pneumonia were subsequently documented by induced sputum examination (n = 54), bronchoalveolar lavage (n = 16), thoracocentesis (n = 1), or autopsy (n = 1). A total of 44 episodes occurred in patients who had not received antipneumocystis prophylaxis, and 28 episodes occurred in patients who had received aerosolized pentamidine. Of patients capable of producing a sputum specimen for analysis, induced sputum examination had a significantly lower diagnostic yield of 64.3% in patients who had received aerosolized pentamidine prophylaxis compared with 92.3% in patients who did not receive prophylaxis (p less than 0.02, Fisher's exact test). When the data were analyzed on an intention to treat basis, although there was a trend suggesting a lower overall yield in the aerosolized pentamidine patients, the difference was not statistically significant (64.3 versus 81.8%, p = 0.17, Fisher's exact test).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/1928945/Effect_of_aerosolized_pentamidine_prophylaxis_on_the_diagnosis_of_Pneumocystis_carinii_pneumonia_by_induced_sputum_examination_in_patients_infected_with_the_human_immunodeficiency_virus_ DB - PRIME DP - Unbound Medicine ER -