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卡氏肺孢子虫性肺炎多见于免疫受损者,常因缺乏有效的治疗而死亡。戊脘脒和TMP-SMZ是目前治疗本病最常用的两种药物。用戊脘脒治疗免疫缺陷伴有卡氏肺孢子虫肺炎的成人或儿童,有效率为45～70％,常用的剂量疗程为静脉或肌肉注射4mg/kg每天一剂×14天,约有24％和10％的病人可出现肾功能和肝功能受损等副作用,最近研究表明戊脘脒经气雾途径给药可避免或减少全身性副作用。TMP-SMZ的疗效与戊脘脒相似,然而无明显副作用,推荐剂量为TMP 15mg+SMZ 75mg/kg/天静脉注射或TMP 20mg+SMZ 100mg/kg/天分4次口服,14天为一个疗程。除上述两药外,已证实有效的药物还有法西达、氨苯砜、二氟甲基鸟氨酸和抗叶酸素。由于本病的高危人群可能被确定,所以有可能进行长期的化学预防。TMP-SMZ有预防作用,每天服TMP 5mg/kg和SMZ 25mg/kg可预防免疫抑制者发生卡氏肺孢子虫肺炎,上述剂量每周连续服3天也可达到同样的预防作用。对TMP和SMZ耐受不良者试用法西达预防也防止发生本病。此外戊脘脒和氨苯砜也有预防作用。
Pneumocystis carinii pneumonia more common in immunocompromised patients, often due to the lack of effective treatment and death. Pentamidine and TMP-SMZ are the two most commonly used drugs for the treatment of this disease. Treatment of immunodeficiency with pentamidine in adults or children with Pneumocystis carinii pneumonia is effective at 45-70%. The usual dose regimen is intravenous or intramuscular injection of 4 mg / kg x 14 days per day for about 24 % And 10% of patients may have side effects such as renal function and impaired liver function, recent studies have shown that administration of pentamidine via the aerosol route can avoid or reduce the systemic side effects. The efficacy of TMP-SMZ is similar to that of pentamidine, but with no apparent side effects. The recommended dose is TMP 15 mg + SMZ 75 mg / kg / day intravenously or TMP 20 mg + SMZ 100 mg / kg / day orally 4 times daily for 14 days . In addition to the above two drugs, the proven effective drugs are faxidac, dapsone, difluoromethylornithine and antifolate. Because of the high risk of this disease may be identified, it is possible to carry out long-term chemical prevention. TMP-SMZ has a preventive effect, taking TMP 5mg / kg and SMZ 25mg / kg every day can prevent Pneumocystis carinii pneumonia in immunosuppressants. The above-mentioned preventive effect can be achieved by taking the above-mentioned doses continuously for 3 days per week. Prevention of TMP and SMZ poor trial of forskide prevent this disease. In addition, pentamidine and dapsone also have a preventive effect.