Nebulized Pentamidine for the Prevention of <italic>Pneumocystis carinii</italic> Pneumonia in AIDS Patients: Experience of 173 Patients and a Review of the Literature

Abstract

Nebulized pentamidine is increasingly used for the prevention of Pneumocystis carinii pneumonia in HIV antibody-positive patients. We report our experience of the efficacy and tolerance of a high dose regimen (300 mg every second week) in 173 HIV-positive patients over a 2 1/2-year period. Only seven episodes of P. carinii pneumonia occurred but 48 patients (28 per cent) died of other AIDS-related illnesses. Patients who had never had an episode of P. carinii infection were less likely to accept long-term prophylaxis (17 of 81), compared to those who had previously been treated for the condition (five of 92). Nebulized pentamidine is an effective form of prophylaxis against P. carinii pneumonia, but long-term mortality is still high in AIDS patients. Side-effects with this regimen were almost always local and confined to the period of nebulization.