February 17, 1984 / 33(6);65-7 Severe Neutropenia during Pentamidine Treatment of Pneumocystis carinii Pneumonia in Patients with Acquired Immunodeficiency Syndrome New York City During November 1983, three patients at one New York City hospital who had the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia (PCP) developed severe neutropenia while being treated with pentamidine isethionate. Since August 1981, 23 other patients with AIDS and PCP had been treated with pentamidine at this institution. None developed neutropenia that could not be explained by the simultaneous administration of another drug. Editorial Note Editorial Note: For each patient, this was the first admission for PCP, and each showed clinical recovery. In two, recovery occurred while on pentamidine therapy. Folinic acid, topical antifungal agents, benzodiazepines, and in one patient, meperidine and diphenhydramine, were administered during the period in which the pentamidine-associated neutropenia developed. Furthermore, despite intensive screening, only a few other infectious agents (G. lamblia, V. parahemolyticus, M. avium-intracellulare, and superficial Candida) complicated these cases. In two of these, neutropenia developed or worsened during the administration of other anti-infective drugs. Thus, despite the close temporal relationship between neutropenia and the administration of pentamidine and the gradual improvement of the neutropenia after withdrawal of the drug, it should not be presumed that these reactions were specifically related to pentamidine. | |
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