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M9470151.TXT
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1994-07-02
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Document 0151
DOCN M9470151
TI Markedly reduced mortality associated with corticosteroid therapy of
Pneumocystis carinii pneumonia in children with acquired
immunodeficiency syndrome.
DT 9409
AU Bye MR; Cairns-Bazarian AM; Ewig JM; Division of Pediatric Pulmonary
Medicine, Columbia Presbyterian; Medical Center, New York, NY.
SO Arch Pediatr Adolesc Med. 1994 Jun;148(6):638-41. Unique Identifier :
AIDSLINE MED/94251314
AB 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.
DE 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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).