Clindamycin/primaquine therapy and secondary prophylaxis against Pneumocystis carinii pneumonia in patients with AIDS.

We found a program of intravenous and subsequent oral clindamycin, combined with oral primaquine, to be effective for Pneumocystis carinii pneumonia in nine patients with AIDS. The pneumonias were either primary or recurrent and sometimes severe, with cavity formation and/or pneumothorax. Maintenance therapy at lowered dose by mouth was effective in preventing recurrence in seven patients. One patient died of other opportunistic infections on day 24, and therapy was discontinued in another on day 11 because of skin rash. We conclude that clindamycin/primaquine is effective for therapy of P carinii pneumonia in patients with AIDS, as well as for long-term secondary prophylaxis at lowered dosage.