Atovaquone suspension compared with aerosolized pentamidine for preventionof Pneumocystis carinii pneumonia in human immunodeficiency virus-infectedsubjects intolerant of trimethoprim or sulfonamides

Atovaquone suspensions (750 mg and 1500 mg once a day) were compared with a erosolized pentamidine (300 mg once a month) for the prevention of Pneumocy stis carinii pneumonia (PCP) in subjects with human immunodeficiency virus (HIV) infection who were intolerant to trimethoprim or sulfonamides (or bot h). Median time using the assigned therapy was 6.6 months, and the median f ollow-up was 11.3 months. Intent-to-treat analyses (n = 549) showed no stat istically significant differences among subjects with regard to the inciden ce of PCP (26%, 22%, and 17%, respectively) or mortality (20%, 13%, and 18% , respectively). The incidence of treatment-limiting adverse events with at ovaquone was significantly higher (P < .01). There was, however, no signifi cant difference in the time using therapy, Incidences of PCP and death were higher in subjects receiving 750 mg of atovaquone than in subjects receivi ng 1500 mg. Atovaquone suspension at 1500 mg once a day has an efficacy sim ilar to that of aerosolized pentamidine for prevention of PCP in HIV-infect ed subjects and is a safe, effective alternative in those who are intoleran t to trimethoprim or sulfonamides.