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The use of intravenous pentamidine for the prophylaxis of Pneumocystis pneumonia in pediatric patients
Authors:Matthijs D Kruizinga  Dorine Bresters  Frans J Smiers  Arjan C Lankester  Robbert GM Bredius
Institution:Department of Pediatric Immunology–Infections and Stem Cell Transplantation, Leiden University Medical Center, Leiden, The Netherlands
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  pentamidine  Pneumocystis  Pneumocystis jiroveci pneumonia  prophylaxis  stem cell transplantation
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