[Ultrasonic nebulised pentamidine for Pneumocystis carinii pneumonia]

Our retrospective study for ultrasonic nebulised pentamidine in 13 patients shows that 7 of 8 patients with Pneumocystis carinii pneumonia (PCP), proven by biopsy examination, were cured (recovery rate, 88%). Two of these 8 patients were mainly treated by nebulised pentamidine and the other 5 patients were administered parenteral pentamidine before the nebulised pentamidine therapy and the final 1 patient died on day 9 without clinical improvement with nebulised pentamidine as well as conventional therapy (trimethoprim-sulphamethoxazole, parenteral pentamidine). No relapse occurred in the 7 cured patients. The inhalation increased the cough in 4 of 13 cases and caused vomiting in 1 patient. Two patients discontinued the nebulisation because of the side-effect. No extra-pulmonary side-effects of nebulised pentamidine were seen. These results show that an efficacy of nebulised pentamidine is at least equal to conventional therapy with fewer side-effects and that only patients with mild PCP without severe hypoxaemia are eligible for the inhalation therapy.