Kruizinga Matthijs D, Bresters Dorine, Smiers Frans J, Lankester Arjan C, Bredius Robbert G M
Department of Pediatric Immunology-Infections and Stem Cell Transplantation, Leiden University Medical Center, Leiden, The Netherlands.
Pediatr Blood Cancer. 2017 Aug;64(8). doi: 10.1002/pbc.26453. Epub 2017 Jan 11.
Pneumocystis jiroveci pneumonia was common in the immunocompromised host before the widespread use of prophylaxis. When trimethoprim-sulfamethoxazole is not tolerated, prophylaxis with intravenous pentamidine (IVP) may be initiated. We performed a retrospective analysis of all pediatric patients who received IVP regarding efficacy, safety, and reason for initiation. Of 106 patients included in our analysis, one patient tested positive for Pneumocystis DNA. Adverse events were reported in 18% of IVP courses, and main reason for initiation was cytopenia (59%). We found IVP to be effective and safe, and recommend the use of IVP in pediatric patients in whom first-line prophylaxis is contraindicated.
在广泛使用预防措施之前，耶氏肺孢子菌肺炎在免疫功能低下的宿主中很常见。当不能耐受复方新诺明时，可开始使用静脉注射喷他脒（IVP）进行预防。我们对所有接受IVP治疗的儿科患者进行了回顾性分析，以评估其疗效、安全性及开始治疗的原因。在我们分析的106例患者中，有1例患者的肺孢子菌DNA检测呈阳性。18%的IVP疗程报告了不良事件，开始治疗的主要原因是血细胞减少（59%）。我们发现IVP有效且安全，并建议在一线预防措施禁忌的儿科患者中使用IVP。
