Assessment of therapy for pneumocystis carinii pneumonia. PCP Therapy Project Group.

Pneumocystis carinii pneumonia has been recognized in about 60 percent of patients with the acquired immune deficiency syndrome (AIDS). The Centers for Disease Control, in collaboration with 19 medical centers, retrospectively studied 282 biopsy-confirmed cases of P. carinii pneumonia to determine the efficacy and safety of anti-Pneumocystis therapy. Adult patients with P. carinii pneumonia secondary to AIDS and to other known causes of immune deficiency were enrolled. AIDS patients experienced a longer time from onset to diagnosis. All patients received the standard treatments for their infections. There was no difference in survival rates through 90 days of follow-up between AIDS patients and adults with known causes of immune deficiency. However, AIDS patients required a longer duration of therapy and experienced a higher rate of relapse. Failure of therapy with trimethoprim/sulfamethoxazole was found to be a poor prognostic sign. After failure of trimethoprim/sulfamethoxazole, measures of patient outcome were similarly affected by adding or substituting pentamidine isethionate.