Since the first edition of this book was published there have been substantial advances in the treatment of human immunodeficiency virus (HIV) infection and the corollary acquired immunodeficiency syndrome (AIDS). Multiregimen antiretroviral therapy has allowed HIV/AIDS to be managed in a manner that was impossible in 1992. The development of successful treatments for HIV/AIDS and the effectiveness of antimicrobials, trimethoprim/sulfamethoxazole or dapsone, in the treatment of Pneumocystic carinii pneumonia (PCP) have reduced pentamidine aerosol therapy to a second-line approach. However, this remains a valuable therapy for treatment of PCP.

The clinical experiences obtained from caring for the increased incidence of PCP in patients with AIDS has led to the conclusion that current oral and intravenous therapies, albeit effective, have significant short- and long-term adverse reactions that often limit use. Two approaches for effective and less toxic antipneumocystosis therapy and prophylaxis are possible: new agents and targeted delivery of known agents. This chapter summarizes the significant studies on aerosolized pentamidine isethionate, which is targeted to the lungs.

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