Risk factors for hypoglycemia associated with pentamidine therapy for Pneumocystis pneumonia
H. Waskin, J. K. Stehr-Green, C. G. Helmick and F. R. Sattler
Division of Parasitic Diseases, Centers for Disease Control, Atlanta.
In 1984, three patients died of severe hypoglycemia after receiving
pentamidine isethionate to treat Pneumocystis pneumonia. These deaths
occurred on days 8, 12, and 19 of treatment, respectively. To assess risk
factors associated with pentamidine treatment and hypoglycemia, we reviewed
records of patients treated with pentamidine in New York City in 1984;
ninety-seven percent of these patients had a diagnosis of acquired
immunodeficiency syndrome. Hypoglycemia occurred in 23 (14%) of 164
patients. Hypoglycemia was more likely to occur in patients who received
therapy of longer duration and an increasing dosage of pentamidine.
Patients at greater risk for hypoglycemia also included those who had
received pentamidine previously and those who experienced azotemia during
treatment. This serious, potentially fatal, reaction should be considered
in all patients who are treated with pentamidine, particularly those
receiving prolonged or recurrent therapy.
