Markedly reduced mortality associated with corticosteroid therapy of Pneumocystis carinii pneumonia in children with acquired immunodeficiency syndrome [see comments]

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Markedly reduced mortality associated with corticosteroid therapy of Pneumocystis carinii pneumonia in children with acquired immunodeficiency syndrome [see comments]

Arch Pediatr Adolesc Med. 1994 Jun;148(6):638-41. Unique Identifier : AIDSLINE MED/94251314
Bye MR; Cairns-Bazarian AM; Ewig JM; Division of Pediatric Pulmonary Medicine, Columbia Presbyterian; Medical Center, New York, NY.

Abstract: BACKGROUND: Pneumocystis carinii pneumonia is a common opportunistic infection in pediatric acquired immunodeficiency syndrome (AIDS). Mortality rates of 34% have been reported for the acute infection, with much higher mortality rates occurring in the presence of respiratory failure. Corticosteroids reduce the morbidity and mortality in adults with AIDS and P carinii pneumonia. We report herein our experience with corticosteroids in P carinii pneumonia in pediatric AIDS. METHODS: When the data on adults were published, we began treating our patients with corticosteroids. We compared these children (group 1) with those children treated in a similar manner, but without corticosteroids (group 2). RESULTS: The two groups had similar ages, initial serum lactate dehydrogenase levels, and initial alveolar-arterial difference in partial pressure of oxygen. There was a significant (P < .001) reduction in the need for mechanical ventilation and in mortality in the corticosteroid-treated group. CONCLUSION: Corticosteroid therapy during acute infection with P carinii in young children with AIDS appears to significantly reduce morbidity (as measured by the need for mechanical ventilation) and mortality.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Case Report Child Child, Preschool Human Injections, Intravenous Methylprednisolone Hemisuccinate/ADMINISTRATION & DOSAGE/ *THERAPEUTIC USE Pneumonia, Pneumocystis carinii/*DRUG THERAPY/*MORTALITY Prednisone/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Survival Rate Treatment Outcome JOURNAL ARTICLE

Comment in: Arch Pediatr Adolesc Med 1995 Aug;149(8):930-1
940930
M9491018

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