Prophylaxis of Pneumocystis carinii pneumonia in human immunodeficiency virus–infected adults

Abstract

In 1992, the feasibility and benefit of preventing Pneumocystis carinii pneumonia are well demonstrated in human immunodeficiency virus–infected patients. Although indications for prophylaxis are also well defined, the incidence of P. carinii pneumonia remains exceedingly high. Among the two recommended agents, trimethoprimsulfamethoxazole appears more effective but also less well tolerated than pentamidine aerosols. Large comparative trials using these agents and others such as dapsone, alone or in combination, are still ongoing; their results may offer alternatives, especially in trimethoprim-sulfamethoxazole–intolerant patients. The next step is to develop new agents or combinations in order to extend the spectrum of prophylactic strategies to other acquired immunodeficiency syndrome–related major opportunistic infections.