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Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia: efficacy, mortality and morbidity.
AIDS. 1994 Jul; 8(7):935-9.AIDS

Abstract

OBJECTIVE

Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with HIV infection has been recommended by the Centers for Disease Control and Prevention. We evaluated alternatives to routine primary PCP prophylaxis with aerosolized pentamidine.

METHODS

A total of 121 HIV-infected patients with CD4+ cell counts < or = 200 x 10(6)/l or an AIDS diagnosis were enrolled in a controlled study of aerosolized pentamidine as primary PCP prophylaxis. Patients were randomly assigned to treatment (n = 61) with aerosolized pentamidine once every month or to no treatment (n = 60). Patients were evaluated for PCP, mortality, morbidity and progression of HIV disease. Morbidity was estimated from the number of days patients were unable to work due to illness, number of days hospitalized and AIDS events.

RESULTS

Baseline characteristics were similar in the treatment and control groups and mean CD4+ cell counts were 116 and 107 x 10(6)/l, respectively. Eight incidents of PCP and 19 deaths were observed in the treatment group during a median follow-up of 16.4 months (range, 2.3-32.4 months). Nineteen incidents of PCP and 13 deaths, of which one was related to an acute episode of PCP, were noted in the control group. Median follow-up of controls was 18.5 months (range, 3.1-32.9 months). Patients in the treatment group were unable to work 19% of the observation time and were hospitalized for 4.3% of that time. Corresponding figures were 20 and 3.0%, respectively, in the control group.

CONCLUSIONS

Aerosolized pentamidine had significant prophylactic efficacy, but we could not detect any major effect on mortality and morbidity. The overall mortality and morbidity were not markedly influenced by PCP. Clinical check-ups and treatment of acute PCP could be a justifiable alternative to drug prophylaxis with aerosolized pentamidine in selected patients.

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Authors+Show Affiliations

Lidman C
Department of Infectious Diseases, Huddinge Hospital, Sweden.
Berglund O
No affiliation info available
Tynell E
No affiliation info available
Lindbäck S
No affiliation info available
Elvin K
No affiliation info available

MeSH

AIDS-Related Opportunistic InfectionsAbsenteeismAcquired Immunodeficiency SyndromeAdultAerosolsDisease ProgressionFemaleFollow-Up StudiesHospitalizationHumansMalePentamidinePneumonia, PneumocystisRisk FactorsSwedenZidovudine

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7946102

Citation

Lidman, C, et al. "Aerosolized Pentamidine as Primary Prophylaxis for Pneumocystis Carinii Pneumonia: Efficacy, Mortality and Morbidity." AIDS (London, England), vol. 8, no. 7, 1994, pp. 935-9.
Lidman C, Berglund O, Tynell E, et al. Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia: efficacy, mortality and morbidity. AIDS. 1994;8(7):935-9.
Lidman, C., Berglund, O., Tynell, E., Lindbäck, S., & Elvin, K. (1994). Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia: efficacy, mortality and morbidity. AIDS (London, England), 8(7), 935-9.
Lidman C, et al. Aerosolized Pentamidine as Primary Prophylaxis for Pneumocystis Carinii Pneumonia: Efficacy, Mortality and Morbidity. AIDS. 1994;8(7):935-9. PubMed PMID: 7946102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia: efficacy, mortality and morbidity. AU - Lidman,C, AU - Berglund,O, AU - Tynell,E, AU - Lindbäck,S, AU - Elvin,K, PY - 1994/7/1/pubmed PY - 1994/7/1/medline PY - 1994/7/1/entrez SP - 935 EP - 9 JF - AIDS (London, England) JO - AIDS VL - 8 IS - 7 N2 - OBJECTIVE: Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with HIV infection has been recommended by the Centers for Disease Control and Prevention. We evaluated alternatives to routine primary PCP prophylaxis with aerosolized pentamidine. METHODS: A total of 121 HIV-infected patients with CD4+ cell counts < or = 200 x 10(6)/l or an AIDS diagnosis were enrolled in a controlled study of aerosolized pentamidine as primary PCP prophylaxis. Patients were randomly assigned to treatment (n = 61) with aerosolized pentamidine once every month or to no treatment (n = 60). Patients were evaluated for PCP, mortality, morbidity and progression of HIV disease. Morbidity was estimated from the number of days patients were unable to work due to illness, number of days hospitalized and AIDS events. RESULTS: Baseline characteristics were similar in the treatment and control groups and mean CD4+ cell counts were 116 and 107 x 10(6)/l, respectively. Eight incidents of PCP and 19 deaths were observed in the treatment group during a median follow-up of 16.4 months (range, 2.3-32.4 months). Nineteen incidents of PCP and 13 deaths, of which one was related to an acute episode of PCP, were noted in the control group. Median follow-up of controls was 18.5 months (range, 3.1-32.9 months). Patients in the treatment group were unable to work 19% of the observation time and were hospitalized for 4.3% of that time. Corresponding figures were 20 and 3.0%, respectively, in the control group. CONCLUSIONS: Aerosolized pentamidine had significant prophylactic efficacy, but we could not detect any major effect on mortality and morbidity. The overall mortality and morbidity were not markedly influenced by PCP. Clinical check-ups and treatment of acute PCP could be a justifiable alternative to drug prophylaxis with aerosolized pentamidine in selected patients. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/7946102/Aerosolized_pentamidine_as_primary_prophylaxis_for_Pneumocystis_carinii_pneumonia:_efficacy_mortality_and_morbidity_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=7946102.ui DB - PRIME DP - Unbound Medicine ER -
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