0
Articles |

The Effect of Adjunctive Corticosteroids for the Treatment of Pneumocystis carinii Pneumonia on Mortality and Subsequent Complications FREE TO VIEW

Joel E. Gallant; Richard E. Chaisson; Richard D. Moore
Author and Funding Information

From the Johns Hopkins University School of Medicine, Baltimore, MD.

Joel E. Gallant, MD, MPH, The Johns Hopkins University School of Medicine, 1830 E Monument St, 4th Floor, Baltimore, MD 21287-6220


1998 by the American College of Chest Physicians


Chest. 1998;114(5):1258-1263. doi:10.1378/chest.114.5.1258
Text Size: A A A
Published online

Abstract

Objective: To assess the long-term safety of adjunctive corticosteroids in the treatment of Pneumocystis carinii pneumonia (PCP).

Design: Analysis of data from a large prospective observational database.

Setting: HIV clinic at a large urban teaching hospital.

Patients: One hundred seventy-four patients who developed PCP after being enrolled in the database.

Results: Fifty-three patients (30%) received adjunctive corticosteroids and 121 (70%) did not. Survival did not differ between groups after adjusting for CD4 count (relative risk for adjunctive corticosteroids = 0.74, p = 0.13). There were no differences in the incidence of cytomegalovirus disease (adjunctive corticosteroids: 18.5 cases per 100 person-years vs no adjunctive corticosteroids: 15.7, p = 0.22), Mycobacterium avium complex (23.4 vs 27.0, p = 0.73), cryptococcal meningitis (1.8 vs 4.1, p = 0.58), toxoplasmosis (3.6 vs 11.0, p = 0.28), Kaposi's sarcoma (1.8 vs 2.2, p = 0.92), herpes simplex (27.1 vs 42.7, p = 0.66), herpes zoster (3.8 vs 6.9, p = 0.71), oropharyngeal candidiasis (18.9 vs 10.9, p = 0.09), or non-Hodgkin's lymphoma (3.5 vs 4.2, p = 0.92). Esophageal candidiasis was more common among adjunctive corticosteroid recipients (45.1 vs 26.6, p = 0.01). Results were similar for time to development of opportunistic conditions.

Conclusions: Adjunctive corticosteroids do not increase mortality or the risk of most common HIV-associated complications.


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Guidelines
Rheumatoid arthritis. The management of rheumatoid arthritis in adults.
National Clinical Guideline Centre for Acute and Chronic Conditions | 9/18/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543