THE ROLE OF ATOVAQUONE TABLETS IN TREATING PNEUMOCYSTIS-CARINII PNEUMONIA

At the start of the AIDS epidemic, the only agents licensed for treatm ent of Pneumocystis carinii pneumonia (PCP) were trimethoprim-sulfamet hoxazole (TMP-SMX) and pentamidine. Both are effective against PCP, bu t their use has been compromised by adverse reactions that necessitate discontinuing therapy in less than or equal to 54% of patients. As a result of the limitations in the use of these therapies, research effo rts have been directed toward the development of effective agents with an improved safety profile. Of these agents, one of the best studied is atovaquone, a hydroxynaphthoquinone that has been licensed by the U .S. Food and Drug Administration for use in the treatment of mild to m oderate PCP in patients intolerant to TMP-SMX. Clinical studies have s hown that atovaquone is associated with overall therapeutic success ra tes equivalent to those of intravenous pentamidine and TMP-SMX, althou gh its therapeutic efficacy rates are somewhat lower. However, atovaqu one is associated with fewer treatment-limiting side effects than the other drugs. The literature concerning the efficacy and safety of atov aquone for the treatment of PCP will be reviewed.