Treatment of Pneumocystis carinii pneumonia: current status of the regimens of pentamidine isethionate and pyrimethamine-sulfadiazine.

A randomized clinical trial is under way comparing the relative merits of pentamidine isethionate and pyrimethamine-sulfadiazine in the management of patients with Pneumocystis carinii pneumonia. Twenty-one patients have entered the trial. Both regimens have produced at least one complete recovery in biopsy-proved pneumocystis pneumonia. Two patients have died from pneumocystis pneumonia after being treated with a combination of both regimens. Initial observations on comparative toxicity indicate pentamidine isethionate has more local toxicity, but pyrimethamine-sulfadiazine is difficult to administer to severely ill patients. Comparative merits of the two regimens will be analyzed at the completion of the present clinical trial.