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Published on: February 23, 2014
Treatment of pneumocystis carinii pneumonia in children
Insights
Pneumocystis pneumonia in children with underlying conditions is treatable. Pentamidine isethionate is effective but has side effects; co-trimoxazole offers a potentially safer alternative.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
Background:
- Pneumocystis carinii pneumonia (PCP) is a serious opportunistic infection.
- Children with congenital immunodeficiency or malignancy are at high risk for PCP.
Purpose of the Study:
- To review treatment outcomes for pediatric PCP.
- To evaluate the efficacy and safety of pentamidine isethionate and co-trimoxazole.
Main Methods:
- Retrospective review of 18 pediatric PCP cases over 16 years.
- Analysis of treatment regimens including pentamidine isethionate and co-trimoxazole.
- Assessment of patient outcomes and treatment-related side effects.
Main Results:
- 15 patients were treated; 12 recovered.
- Untreated patients (3) died.
- Pentamidine isethionate showed efficacy but significant side effects (hypoglycemia, uremia).
- Co-trimoxazole appeared effective and less toxic.
Conclusions:
- Pentamidine isethionate is an effective treatment for pediatric PCP.
- Co-trimoxazole is a viable, potentially safer alternative.
- Prompt treatment is crucial for survival in immunocompromised children.
Abstract:
Eighteen children with pneumocystis carinii pneumonia diagnosed over a period of 16 years at a children's hospital are reviewed. All had an underlying disease, either congenital immunodeficiency or a malignancy. 15 patients were treated, 10 with pentamidine isethionate alone, 2 with both pentamidine and co-trimoxazole, and 3 with co-trimoxazole alone. 12 of the treated group recovered and the 3 untreated patients died. The 3 deaths after treatment occurred in children receiving pentamidine alone, and in whom secondary factors contributed. The side effects of treatment with pentamidine were high, and included local reactions, hypoglycaemia, and uraemia. However, our results confirm that pentamidine is an effective treatment for pneumocystis carinii pneumonia in childhood. Co-trimoxazole may be an effective and relatively nontoxic alternative treatment.
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