AEROSOLIZED PENTAMIDINE PROPHYLAXIS IN HI V-INFECTION - COMPARISON OF2 NEBULIZE RESPIRGARD-II VERSUS ATOMISOR NL5F

In a randomized trial conducted in HIV patients requiring prophylaxis against pneumocystosis, we compared two nebulizers (Respirgard II and Atomisor NL5F). Mass median aerodynamic diameter (MMAD) are comparable for the two nebulizers (Respirgard II - 1,42 mum ; Atomisor NL5F = 1, 8 mum). The 76 patients were randomized to one or the other nebulizer. Tolerance was evaluated on clinical criteria : (cough, dyspnea ... ) and on the variation of the peak expiratory flow after each aerosol. T he Atomisor NL5F tended to produce more side-effects than the Respirga rd II, but the difference was not significant. The best expiratory fil ter (capacity of retention : 99,97 % for > 0,4 mum diameter particules ) of the Atomisor NL5F should reduce the risks of occupational exposur e of health care workers and prevent environmental contamination by re spiratory pathogens, especially Mycobacterium tuberculosis. The greate r risk of aerosolized pentamidine is transmission of tuberculosis from undiagnosed cases. Tuberculose control measures such as improved vent ilation and masks should also include the use of nebulizer with high r etention expiratory filter.