A 5-year retrospective review of adverse drug reactions and their risk factors in human immunodeficiency virus-infected patients who were receiving intravenous pentamidine therapy for Pneumocystis carinii pneumonia.

The incidence and severity of adverse drug reactions (ADRs) in human immunodeficiency virus-infected persons receiving intravenous pentamidine for Pneumocystis carinii pneumonia during a 5-year period were reviewed retrospectively. Predisposing risk factors for ADRs were identified. ADRs were included if they occurred during or within 1 week following the discontinuation of pentamidine treatment. Nephrotoxicity, dysglycemia, hepatotoxicity, hyperkalemia, and hyperamylasemia accounted for 80% of ADRs (n = 174) that occurred in 76 (71.7%) of 106 patients during 84 treatment courses of pentamidine. A significant relationship between hypoglycemia and nephrotoxicity was observed (P = .002). Four factors were significantly associated with occurrence of an ADR: number of concomitant medications (odds ratio [OR] = 1.36, P = .005), nonwhite ethnicity (OR = 5.00, P = .017), cumulative dosage of pentamidine (OR = 1.03, P = .030), and concurrent use of other nephrotoxic drugs (OR = 2.34, P = .047). Two factors, daily dosage and history of intravenous drug use, approached significance. Knowledge of and avoidance of potential risk factors might allow safer use of pentamidine and reduce the prevalence of ADRs.