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Pentamidinaerosol in der Prophylaxe und Therapie von Pneumocystis carinii Pneumonien bei Aids-Patienten

  • H. Lode
  • G. Höffken
  • N. Deppermann
  • D. Mainz
  • M. Petri
Conference paper
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Zusammenfassung

Das erworbene Immundefektsyndrom (Aids) ist klinisch durch das Auftreten von Infektionen, ausgelöst durch opportunistische Erreger, und von Tumoren, gekennzeichnet. Nach Angaben der WHO zur Aids-Verbreitung in Europa leiden 80% dieser Patienten an Infektionen, wobei Pneumocystis carinii als Erreger interstitieller Pneumonien am häufigsten nachgewiesen wird (Stover et al. 1985; Wharton et al. 1986; WHO-Bericht 1986). Die Behandlung einer Pneumocystis carinii Pneumonie (PcP) bei Patienten ohne Aids ist gut dokumentiert (Walzer et al. 1974; Western et al. 1970; Winston et al. 1980). Sowohl Pentamidin als auch Cotrimoxazol sind in der Behandlung dieser früher seltenen Infektionskrankheit wirksam. Vergleichsuntersuchungen belegen die äquivalente klinische Effektivität beider Substanzen (Hughes et al. 1978). Auffällig bei der Behandlung von Aids-Patienten mit PcP waren allerdings die beträchtlichen Unverträglichkeitsreaktionen sowohl mit Cotrimoxazol wie auch mit parenteralem Pentamidin (Gordin et al. 1984; Western et al. 1970; Wharton et al. 1986). Auch neuere Studien mit Reduktion der Trimethoprim-Sulfamethoxazol-Dosis (15–12 mg/kg Trimethoprim täglich) erbrachten zwar eine Senkung der Unverträglichkeitsreaktionen (44% Exantheme, 39% Anämien), jedoch war diese Rate an Nebenwirkungen immer noch verhältnismäßig hoch; allerdings verursachte Pentamidin in dieser Studie (Sattler et al. 1988) noch höhere Unverträglichkeitsraten bei auch niedrigen Dosierungen zwischen 3,1 und 4,0 mg/kg Körpergewicht täglich mit 64% Nephrotoxizität, 27% Hypotension und 21% Hypoglykämie.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • H. Lode
  • G. Höffken
  • N. Deppermann
  • D. Mainz
  • M. Petri

There are no affiliations available

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