Related Experiment Video
Updated: May 3, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Inhaled or reduced-dose intravenous pentamidine for Pneumocystis carinii pneumonia. A pilot study
Study Objective:
To evaluate inhaled or reduced-dose intravenous pentamidine for the treatment of patients with mild Pneumocystis carinii pneumonia.
Design:
Open, nonrandomized pilot study; measurement of pentamidine concentrations in plasma and bronchoalveolar lavage fluid.
Patients:
Of 22 men with mild P. carinii pneumonia (PO2 greater than or equal to 55 mm Hg), 15 (9 in the inhaled group and 6 in the intravenous group) received treatment for their first episode and 7 for a repeat episode.
Interventions:
Pentamidine isethionate, 4 mg/kg body weight by inhalation, or 3 mg/kg intravenously, was given once daily, as long as clinically indicated.
Measurements And Main Results:
Of the 13 patients in the inhaled group, 9 has a satisfactory response; and of the 10 in the reduced-dose intravenous group, 9 had a satisfactory response. Major adverse reactions occurred in two patients in each group. Three patients in the inhaled group appeared to have had early relapses. Bronchoalveolar lavage fluid concentrations of pentamidine ranged between 16.8 +/- 7.3 ng/mL and 149.7 +/- 38.2 ng/mL in the inhaled group and 3.4 +/- 0.2 ng/mL and 10.9 ng/mL in the intravenous group.
Conclusions:
Inhaled or reduced-dose intravenous pentamidine may be an effective and less toxic therapy for mild P. carinii pneumonia. These regimens are not recommended for general use until larger controlled trials are conducted.
Insights
Inhaled or IV pentamidine shows promise for mild Pneumocystis pneumonia. Further trials are needed to confirm effectiveness and safety for this P. carinii infection treatment.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pharmacology
Background:
- Pneumocystis carinii pneumonia (PCP) is a significant opportunistic infection.
- Standard pentamidine therapy can have considerable toxicity.
- Exploring alternative, less toxic treatment regimens is crucial.
Purpose of the Study:
- To assess the efficacy and safety of inhaled versus reduced-dose intravenous pentamidine for mild PCP.
- To measure pentamidine concentrations in plasma and bronchoalveolar lavage fluid.
Main Methods:
- An open, nonrandomized pilot study was conducted.
- Patients with mild PCP received either inhaled (4 mg/kg) or IV (3 mg/kg) pentamidine daily.
- Plasma and bronchoalveolar lavage fluid pentamidine levels were measured.
Main Results:
- Satisfactory responses were observed in 9 of 13 patients (inhaled group) and 9 of 10 patients (IV group).
- Major adverse reactions occurred in two patients in each group.
- Bronchoalveolar lavage fluid pentamidine concentrations varied significantly between inhaled and IV administration.
Conclusions:
- Both inhaled and reduced-dose IV pentamidine appear to be effective and potentially less toxic options for mild PCP.
- These novel treatment strategies require validation through larger, controlled clinical trials before widespread adoption.
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