83202
document
Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia : efficacy , mortality and morbidity . 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 .
83203
Intervention_Pharmacological
Aerosolized pentamidine
83204
Intervention_Pharmacological
aerosolized pentamidine .
83205
Intervention_Pharmacological
aerosolized pentamidine
83206
Intervention_Pharmacological
aerosolized pentamidine
83207
Intervention_Control
no treatment
83208
Intervention_Pharmacological
Aerosolized pentamidine
83209
Intervention_Pharmacological
aerosolized pentamidine
83210
Outcome_Physical
Pneumocystis carinii pneumonia :
83211
Outcome_Physical
PCP ,
83212
Outcome_Mortality
mortality
83213
Outcome_Physical
, morbidity and progression of HIV disease .
83214
Outcome_Physical
CD4+ cell counts
83215
Outcome_Mortality
deaths
83216
Outcome_Mortality
deaths
83217
Outcome_Physical
Median follow-up
83218
Outcome_Other
observation time
83219
Outcome_Physical
prophylactic efficacy
83220
Outcome_Mortality
mortality and morbidity .
83221
Outcome_Mortality
mortality
83222
Outcome_Mortality
morbidity
83223
Outcome_Physical
justifiable
83224
Participant_Condition
patients with HIV infection
83225
Participant_Condition
A total of
83226
Participant_Sample-size
121
83227
Participant_Condition
HIV-infected patients with CD4+ cell counts < or = 200 x 10 ( 6 ) /l or an AIDS diagnosis