A retrospective study of intravenous pentamidine for Pneumocystis jirovecii pneumonia prophylaxis in adult patients with hematologic malignancies-its utility during respiratory virus pandemics.

Autor:	Liew YX; Department of Pharmacy, Singapore General Hospital, Singapore., Ho AYL; Department of Haematology, Singapore General Hospital, Singapore; Singhealth Duke-NUS Transplant Centre, Singapore., Wong GC; Department of Haematology, Singapore General Hospital, Singapore., Chung SJ; Singhealth Duke-NUS Transplant Centre, Singapore; Singhealth Duke-NUS Medicine Academic Clinical Programme, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore., Tan TT; Singhealth Duke-NUS Transplant Centre, Singapore; Singhealth Duke-NUS Medicine Academic Clinical Programme, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore., Tan BH; Singhealth Duke-NUS Transplant Centre, Singapore; Singhealth Duke-NUS Medicine Academic Clinical Programme, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore. Electronic address: tan.ban.hock@sgh.com.sg.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Jun; Vol. 143, pp. 107059. Date of Electronic Publication: 2024 Apr 16.
DOI:	10.1016/j.ijid.2024.107059
Abstrakt:	Objectives: In hematology, prophylaxis for Pneumocystis jirovecii pneumonia (PCP) is recommended for patients undergoing hematopoietic stem cell transplantation and in selected categories of intensive chemotherapy for hematologic malignancies. Trimethoprim-sulfamethoxazole (TMP-SMX) is the recommended first-line agent; however, its use is not straightforward. Inhaled pentamidine is the recommended second-line agent; however, aerosolized medications were discouraged during respiratory virus outbreaks, especially during the COVID-19 pandemic, in view of potential contamination risks. Intravenous (IV) pentamidine is a potential alternative agent. We evaluated the effectiveness and tolerability of IV pentamidine use for PCP prophylaxis in adult allogeneic hematopoietic stem cell transplantation recipients and patients with hematologic malignancies during COVID-19. Results: A total of 202 unique patients who received 239 courses of IV pentamidine, with a median of three doses received (1-29). The largest group of the patients (49.5%) who received IV pentamidine were undergoing or had received a hematopoietic stem cell transplant. The most common reason for not using TMP-SMX prophylaxis was cytopenia (34.7%). We have no patients who had breakthrough PCP infection while on IV pentamidine. None of the patients developed an infusion reaction or experienced adverse effects from IV pentamidine. Conclusions: Pentamidine administered IV monthly is safe and effective. Competing Interests: Declarations of Competing Interest The authors have no competing interests to declare. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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