The use of intravenous pentamidine for the prophylaxis of Pneumocystis pneumonia in pediatric patients

Pediatr Blood Cancer. 2017 Aug;64(8). doi: 10.1002/pbc.26453. Epub 2017 Jan 11.

Abstract

Pneumocystis jiroveci pneumonia was common in the immunocompromised host before the widespread use of prophylaxis. When trimethoprim-sulfamethoxazole is not tolerated, prophylaxis with intravenous pentamidine (IVP) may be initiated. We performed a retrospective analysis of all pediatric patients who received IVP regarding efficacy, safety, and reason for initiation. Of 106 patients included in our analysis, one patient tested positive for Pneumocystis DNA. Adverse events were reported in 18% of IVP courses, and main reason for initiation was cytopenia (59%). We found IVP to be effective and safe, and recommend the use of IVP in pediatric patients in whom first-line prophylaxis is contraindicated.

Keywords: PCP; Pneumocystis; Pneumocystis jiroveci pneumonia; pentamidine; prophylaxis; stem cell transplantation.

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Child
  • Female
  • Humans
  • Immunocompromised Host / drug effects*
  • Male
  • Pentamidine / therapeutic use*
  • Pneumonia, Pneumocystis / prevention & control*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Retrospective Studies
  • Stem Cell Transplantation

Substances

  • Antifungal Agents
  • Pentamidine