| The possible role of corticosteroid therapy for pneumocystis pneumonia in the acquired immune deficiency syndrome (AIDS). | |
| | |
MedLine Citation:
|
PMID: 3265156 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Twenty-one episodes of Pneumocystis carinii pneumonia (PCP) and the acquired immune deficiency syndrome (AIDS) were treated with corticosteroids in the form of intravenous methylprednisolone or oral prednisone. A standard dose of 80 mg/day x 5 days was given for 15 episodes, whereas 6 patients received variable doses of 20-120 mg/day x 4-20 days. All were treated with trimethoprim-sulfamethoxazole (TMP-SMX). Comparison was made with 12 AIDS patients with PCP who were not treated with steroids. The steroid group was more severely ill than the controls as measured by alveolar-arterial oxygen difference but were otherwise comparable. Mortality from the pneumonia in the steroid group was 2/21 (10%) vs. 3/12 (25%) in the control group. Significant differences were seen in the following parameters: time to defervescence (1 day vs. greater than 9.3 days), the proportion of patients with pO2 greater than 70 mm Hg at day 5 [12/21 (57%) vs. 1/12 (9%)] and at day 10 [19/21 (90%) vs. 7/12 (58%)], and number of adverse drug reactions [4/21 (19%) vs. 9/12 (75%)]. There were fewer late relapses [1/19 (5%) vs. 2/9 (22%)] after a 5.5 month (mean) follow-up. All patients had improvements in their clinical status when initially given corticosteroid therapy but early relapses occurred when steroids were discontinued in five patients (24%). No other complications could be attributed to steroid therapy in this study. A brief course of high-dose corticosteroids appears to be beneficial in severely ill AIDS patients with pneumocystis pneumonia. This suggests the need for randomized, double-blind, placebo-controlled trials to confirm these findings. |
| | |
Authors:
|
S Walmsley; I E Salit; J Brunton |
Related Documents
:
|
11157146 - Pilot study of anti-thymocyte globulin plus mycophenolate mofetil in recent-onset diffu... 23267756 - Dorsal carpal wedge osteotomy in the arthrogrypotic wrist. 2285606 - Long-term treatment with antiandrogens. 17222316 - Long-term outcome of crohn's disease following corticosteroid-induced remission. 19834376 - The protective status of subtotal obliteration of arteriovenous malformations after rad... 21261146 - Micu care delivered by pas versus residents: do pas measure up? |
Publication Detail:
|
Type: Clinical Trial; Controlled Clinical Trial; Journal Article |
Journal Detail:
|
Title: Journal of acquired immune deficiency syndromes Volume: 1 ISSN: 0894-9255 ISO Abbreviation: J. Acquir. Immune Defic. Syndr. Publication Date: 1988 |
Date Detail:
|
Created Date: 1989-02-24 Completed Date: 1989-02-24 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8812597 Medline TA: J Acquir Immune Defic Syndr Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 354-60 Citation Subset: IM; X |
Affiliation:
|
Department of Medicine, Toronto General Hospital, Ontario, Canada. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acquired Immunodeficiency Syndrome
/
complications* Adult Drug Administration Schedule Humans Male Methylprednisolone / administration & dosage, therapeutic use* Middle Aged Pilot Projects Pneumonia, Pneumocystis / drug therapy* Prednisone / administration & dosage, therapeutic use* Pulmonary Gas Exchange Sulfamethoxazole / administration & dosage, therapeutic use* Trimethoprim / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
53-03-2/Prednisone; 723-46-6/Sulfamethoxazole; 738-70-5/Trimethoprim; 83-43-2/Methylprednisolone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Improved HIV antiglycoprotein antibody detection by immunoblotting on a hydrophobic membrane.
Next Document: Diagnosis and patterns of incidence of influenza, influenza-like illness and the common cold in gene...