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Drug spray strikes out in severe pneumonia.

Drug spray strikes out in severe pneumonia

Scientists know that an aerosol form of the drug pentamidine can help prevent Pneumocystis carinii pneumonia, a deadly infection that strikes many people with AIDS. They also know that intravenous injections of pentamidine effectively combat established. P. carinii infections. However, intravenous pentamidine often causes severe side effects such as nausea and blood disorders, whereas the inhaled form generally produces nothing more serious than a cough. The FDA has approved aerosol pentamidine as a pneumonia preventer but not as a treatment for full-blown P. carinii pneumonia. Nevertheless, the spray's milder side effects have prompted many physicians to prescribe it for established infections.

Now, however, a preliminary study shows that while inhaled pentamidine works effectively in mild pneumonia, it sometimes fails in more advanced cases.

Guy Soo Hoo and his colleagues at the University of California, Los Angeles, studied 21 homosexual men with AIDS who had developed mild to moderate P. carinii pneumonia. For 21 days, they administered aerosol pentamidine to 11 of the men and the intravenous version to the remaining 10 participants. Five of the men in the spray group showed a worsening in pneumonia symptoms after about seven days of treatment. Three of those five eventually improved after teh researchers switched them to intravenous pentamidine or another standard pneumonia-fighting agent, but the other two patients subsequently died of advanced pneumonia. In contrast, pneumonia symptoms subsided in all 10 men in the intravenous group, the researchers say.

A closer examination of the five who did not respond to the spray revealed they had entered the study with a more severe pneumonia than originally believed. Soo Hoo says people with severely diseased lungs may not be able to inhale enough of the drug to fight the tricky P. carinii. The team must complete larger trials to verify its finding that aerosol pentamidine has limited efficacy in advanced cases, he adds.
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Title Annotation:pentamidine
Author:Fackelmann, Kathy A.
Publication:Science News
Date:Jun 2, 1990
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