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The use of aerosolized pentamidine for prophylaxis of Pneumocystis carinii pneumonia in children with leukemia
Author(s) -
O'Sullivan Brian P.,
Spaulding Rhoda
Publication year - 1994
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950180406
Subject(s) - medicine , pentamidine , pneumocystis carinii , pneumonia , inhalation , trimethoprim , respiratory disease , leukemia , aerosolization , pediatrics , anesthesia , antibiotics , pneumocystis jirovecii , lung , microbiology and biotechnology , biology
We report our experience giving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP) to 9 children (mean age, 7.33 years; range 3–17 years) with leukemia who were unable to tolerate trimethoprim‐sulfamethoxazole (TMP‐SMX) due to allergy or myelosuppression. The dose of pentamidine was modified for each child to correct for weight and approximate alveolar ventilation. We were able to administer the drug to younger children by using a cushioned face mask in place of the standard mouthpiece. One child experienced moderate coughing with administration of pentamidine. He and four others with a past medical history suggestive of reactive airways disease were pretreated with inhaled albuterol. No other adverse effects were noted. Treatment lasted an average of 8.11 ± 4.1 months per child; no case of PCP occurred. We conclude that aerosolized pentamidine can be administered to even very young children and may be of benefit to all immunosuppressed children unable to use TMP‐SMX prophylaxis. The adjusted dose used here appears to be safe, but further studies regarding drug delivery and efficacy are needed. Pediatr Pulmonol. 1994;18:226–231 . ©1994 Wiley‐Liss, Inc.