ADVANCES IN THE TREATMENT AND PROPHYLAXIS OF PNEUMOCYSTIS-CARINII PNEUMONIA

Pneumocystis carinii pneumonia (PCP) is the most common illness associ ated with the acquired-immunodeficiency syndrome (AIDS) in the United States and also occurs in immunocompromised persons not infected with the human immunodeficiency virus.. Several advances have taken place i n the treatment and prophylaxis of PCP, with most clinical trials cond ucted in patients with AIDS. Treatment of choice is trimethoprim-sulfa methoxazole (TMP-SMX). Desensitization regimens are available for thos e who have a fever or rash associated with the agent. Patients with se vere PCP who cannot tolerate TMP-SMX may be treated successfully with pentamidine or trimetrexate. Those with mild to moderate disease may r eceive dapsone-trimethoprim, clindamycin-primaquine, or atovaquone if they cannot take TMP-SMX. Adjunctive therapy with corticosteroids impr oves the outcome in patients with AIDS and severe PCP.