Black JR, Feinberg J, Fass RJ, Plouffe JF, Murphy R, Leoung G; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 291 (abstract no. T.B.P.30).
Indiana University, Indianapolis, IN, USA
OBJECTIVE: An open-labelled, pilot study to determine safety and efficacy of clindamycin and primaquine for treatment of mild (A - a gradient less than 30 mm/Hg) PC pneumonia in AIDS patients. METHODS: Histologically proven PC pneumonia was required for entry. Patients were excluded if they had received prior antiprotozoal therapy or prophylaxis within 6 weeks prior to entry, or if they had significant diarrhea, absolute granulocyte count (AGC) less than 1000/mm(3), platelet count less than 100,000/mm(3), Hgb less than 10 gm, creatinine greater than 2mg/dl, or SGOT greater than 5 times normal. Clindamycin 900 mg IV every 8 hours plus primaquine 30 mg orally per day were administered for the first 10 days. Clindamycin dosing was then changed to 450 mg orally every 6 hours if patients met defined criteria for clinical response. Total duration of treatment was 21 days. Outcome was determined by a pneumonia scoring system incorporating fever, respiratory rate, dyspnea, cough, chest tightness, supplemental oxygen requirement and chest X-ray, and by change in A - a gradient. Bimonthly aerosol pentamidine prophylaxis was begun 2 wks after completing therapy. RESULTS: All 8 patients entered to date showed marked improvement by the 7th day of treatment. Six patients completed treatment with clindamycin and primaquine and were cured. Two patients experienced side effects mandating change to standard therapy during the second week; one developed fever and rash, the other transient, severe neutropenia (AGC of 300). Both were cured. Additional minor side effects included rash, mild neutropenia, and mild methemoglobinemia. No relapses have yet occurred (mean follow-up after treatment: 8 weeks; range: 1-21 weeks). An additional 3 patients were treated in San Francisco with a totally oral clindamycin and primaquine regimen. All improved clinically but failed to complete 21 days of treatment due to rash (2) or mild transaminase elevation (1). CONCLUSIONS: Although further study is warranted, clindamycin and primaquine may represent an alternative treatment for PC pneumonia in AIDS.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Clindamycin
- Drug Therapy, Combination
- Humans
- Pentamidine
- Pilot Projects
- Pneumonia
- Pneumonia, Pneumocystis
- Primaquine
- Recurrence
- San Francisco
- drug therapy
- surgery
- therapy
Other ID:
UI: 102177268
From Meeting Abstracts