Castro M
Department of Internal Medicine, Washington University School of Medicine, St Louis, MO 63110-1093, USA.
Semin Respir Infect. 1998 Dec;13(4):296-303.
Early effective management of Pneumocystis carinii pneumonia improves outcome in patients with this disorder. Trimethoprim-sulfamethoxazole remains the agent of choice for treatment of severe P. carinii pneumonia. Pentamidine, trimethoprim-dapsone, atovaquone, and other regimens are useful in selected clinical situations. Adjunctive corticosteroids are indicated in patients with acquired immune deficiency syndrome and P. carinii pneumonia who have moderate to severe P. carinii pneumonia defined as a room air arterial PaO2 less than 70 mm Hg or an alveolar-arterial oxygen gradient of greater than 35 mm Hg. The use of trimethoprim-sulfamethoxazole, dapsone, and aerosolized pentamidine in immunocompromised patients without AIDS is also reviewed.
卡氏肺孢子虫肺炎的早期有效管理可改善患有该疾病患者的预后。甲氧苄啶-磺胺甲恶唑仍是治疗重度卡氏肺孢子虫肺炎的首选药物。喷他脒、甲氧苄啶-氨苯砜、阿托伐醌及其他治疗方案在特定临床情况下有用。对于获得性免疫缺陷综合征合并卡氏肺孢子虫肺炎且患有中度至重度卡氏肺孢子虫肺炎（定义为室内空气条件下动脉血氧分压低于70 mmHg或肺泡-动脉氧梯度大于35 mmHg）的患者，应使用辅助性皮质类固醇。本文还综述了在无艾滋病的免疫功能低下患者中使用甲氧苄啶-磺胺甲恶唑、氨苯砜及雾化喷他脒的情况。
