Clindamycin and primaquine therapy for mild-to-moderate episodes of pneumocystis carinii pneumonia in patients with aids: Aids clinical trials group 044

John R. Black, Judith Feinberg, Robert L. Murphy, Robert J. Fass, Dianne Finkelstein, Bisher Akil, Sharon Safrin, John T. Carey, John Stansell, Joseph F. Plouffe, Weili He, Brent Shelton, Fred R. Sattler

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

The objective of this prospective, noncomparative study was to assess the safety and efficacy of clindamycin and primaquine therapy for mild-to-moderate pneumocystis pneumonia (defined as a difference of <40 mm Hg between the alveolar and the arterial oxygen determinations) in patients with AIDS. In the first part of the study, 22 patients were treated with iv clindamycin (900 mg every 8 hours) for the first 10 days, and then their therapy was switched to oral clindamycin (450 mg every 6 hours) for an additional 11 days. In the second part of the study, 38 patients were treated entirely with oral clindamycin (600 mg every 8 hours). All patients were treated with oral primaquine base (30 mg once daily). Fifty-five (92%) of 60 patients responded to the study treatment. Forty-six (77%) of 60 patients completed a full course of therapy. Of the nine patients with treatment-limiting toxic effects, four had only a mild rash. This study indicates that the combination of clindamycin and primaquine is an effective and well-tolerated therapy for mild-to-moderate pneumocystis pneumonia in patients with AIDS. Entirely oral therapy appears to be as effective as initial therapy with iv clindamycin.

Original languageEnglish
Pages (from-to)905-913
Number of pages9
JournalClinical Infectious Diseases
Volume18
Issue number6
DOIs
StatePublished - Jun 1994

Bibliographical note

Funding Information:
Received 4 August 1993; revised 24 January 1994. This work was presented in part at the 5th International Conference on AIDS held on 6 June 1989 in Montreal (abstract no T.B.P.30) and at the 7th International Conference on AIDS held on 20 June 1991 in Florence. Italy (abstract no Th.B.42). Informed consent was obtained from all patients. and the guidelines for human experimentation of the U.S. Department of Health and Human Services were followed. Approval was obtained from the Committees on the Protection of Human Subjects at each participating institution. Grant support: The AIDS Clinical Trials Units at the participating institutions receive grant support from the Division ofAIDS of the National Institute of Allergy and Infectious Diseases. * Present address: Methodist Hospital of Indiana. Indianapolis. Indiana. t Present address: Johns Hopkins University Hospital. Baltimore. Maryland. t Present address: Department of Biostatistics. University of North Carolina. Chapel Hill. North Carolina. Reprints or correspondence: Dr. John R. Black. Methodist Hospital of Indiana. 1633 North Capitol Street. Suite 700. Indianapolis. Indiana 46202.

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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