Journal Article

Corticosteroids as Adjunctive Therapy for Severe <i>Pneumocystis carinii</i> Pneumonia in Non-Human Immunodeficiency Virus-Infected Patients: Retrospective Study of 31 Patients

Christophe Delclaux, Jean-Ralph Zahar, Gibba Amraoui, Ghislaine Leleu, François Lebargy, Laurent Brochard, Benoit Schlemmer and Christian Brun Buisson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 3, pages 670-672
Published in print September 1999 | ISSN: 1058-4838
Published online September 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/598651
Corticosteroids as Adjunctive Therapy for Severe Pneumocystis carinii Pneumonia in Non-Human Immunodeficiency Virus-Infected Patients: Retrospective Study of 31 Patients

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The aim of this retrospective study was to assess whether corticosteroid adjunctive therapy (CAT) could prevent death in immunocompromised patients with severe Pneumocystis carinii pneumonia (PCP) who do not have human immunodeficiency virus (HIV) infection, similarly to what has been demonstrated for HIY-infected patients. The charts of all non-HIY-infected patients who were admitted to two medical intensive care units between 1988 and 1996 because of severe PCP, defined by an arterial oxygen pressure (determined while the patient was breathing room air) of <70 rom Hg, and who were treated with trimethoprim-sulfarnethoxazole were analyzed retrospectively. Thirtyone patients met the study criteria, of whom 23 received CAT (within 72 hours of antibiotic therapy) and eight did not receive CAT. The need for mechanical ventilation (10 [43%] of 23 vs. 4 [50%] of 8) and the mortality rate (9 [39%] of 23 vs. 4 [50%] of 8) were similar for the two groups. Although this small study does not have a statistical power high enough to rule out the possibility of a difference, the results suggest that CAT does not improve the survival of non-HIV-infected patients as has been described for HIV-infected patients with severe PCP.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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