[Pentamidine aerosol in the preventive treatment of pneumocystosis in AIDS patients. Comparison of two salts and two nebulizers]. / Aérosol de pentamidine dans la prévention des pneumocystoses des malades atteints de SIDA. Comparaision de deux sels et de deux systèmes de nébulisation.

ABSTRACT

In a randomized trial conducted in AIDS patients requiring prophylaxis against pneumocystosis we compared two pentamidine salts, isethionate (I) and mesylate (M), and two nebulizers (a modified ultrasonic Ultraneb 99 Devilbiss nebulizer, and a disposable jet nebulizer). Patients were randomized to one or the other nebulizer and received alternatively, once every other week, the two pentamidine salts in the IMIM or MIMI order. Characteristics and the side effects of the two courses of each pentamidine salt, as well as drug delivery by each nebulizer during the first course, were studied in 48 patients. The ultrasonic nebulizer was more effective (nebulization time 19.8 +/- 7.3 mn versus 30.7 +/- 11 mn) and produced less side-effects (FEV1 decrease 186 +/- 677 versus 571 +/- 708 ml) than the jet nebulizer. The mesylate salt tended to produce more side-effects than the isethionate, but the difference was not significant (FEV1 decreases 439 +/- 688 ml and 295 +/- 756 ml respectively). We concluded that the best therapeutic procedure is to use pentamidine isethionate delivered by the ultrasonic nebulizer.