Atovaquone Suspension Compared with Aerosolized Pentamidine for Prevention of Pneumocystis carinii Pneumonia in Human Immunodeficiency Virus—Infected Subjects Intolerant of Trimethoprim or Sulfonamides

• Published in: The Journal of infectious diseases 1999-08, Vol.180 (2), p.369-376
• Main Authors: Chan, Charles, Montaner, Julio, Lefebvre, Eric-Albert, Morey, Gary, Dohn, Michael, McIvor, R. Andrew, Scott, Janna, Marina, Raymond, Caldwell, Paul
• Format: Article
• Language: English
• Subjects: Adult; Aged; AIDS; AIDS-Related Opportunistic Infections - prevention & control; Anti-Infective Agents - adverse effects; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal Agents - administration & dosage; Antifungal Agents - adverse effects; Antifungal Agents - therapeutic use; Antiparasitic agents; Atovaquone; Biological and medical sciences; Exanthema; Female; HIV; HIV Infections - mortality; Human immunodeficiency virus 1; Human viral diseases; Humans; Incidence; Infections; Infectious diseases; Major Articles; Male; Medical sciences; Medications; Middle Aged; Mortality; Naphthoquinones - administration & dosage; Naphthoquinones - adverse effects; Naphthoquinones - therapeutic use; Pentamidine; Pentamidine - administration & dosage; Pentamidine - adverse effects; Pentamidine - therapeutic use; Pharmacology. Drug treatments; Pneumocystis carinii; Pneumocystis pneumonia; Pneumonia, Pneumocystis - epidemiology; Pneumonia, Pneumocystis - prevention & control; Statistical results; Statistical significance; Sulfonamides - adverse effects; Trimethoprim - adverse effects; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/314893

Atovaquone suspensions (750 mg and 1500 mg once a day) were compared with aerosolized pentamidine (300 mg once a month) for the prevention of Pneumocystis carinii pneumonia (PCP) in subjects with human immunodeficiency virus (HIV) infection who were intolerant to trimethoprim or sulfonamides (or both). Median time using the assigned therapy was 6.6 months, and the median follow-up was 11.3 months. Intent-to-treat analyses (n = 549) showed no statistically significant differences among subjects with regard to the incidence of PCP (26%, 22%, and 17%, respectively) or mortality (20%, 13%, and 18%, respectively). The incidence of treatment-limiting adverse events with atovaquone was significantly higher (P < .01). There was, however, no significant difference in the time using therapy. Incidences of PCP and death were higher in subjects receiving 750 mg of atovaquone than in subjects receiving 1500 mg. Atovaquone suspension at 1500 mg once a day has an efficacy similar to that of aerosolized pentamidine for prevention of PCP in HIV-infected subjects and is a safe, effective alternative in those who are intolerant to trimethoprim or sulfonamides.