Pafuramidine for Pneumocystis jiroveci pneumonia in HIV-infected individuals

Abstract

Pneumocystis jiroveci pneumonia remains one of the major worldwide contributors to the morbidity and mortality of those with HIV infection. The mainstay of therapy for treatment is trimethoprim–sulfamethoxazole (TMP–SMX); however TMP–SMX may be associated with significant side effects and intolerability. In addition, TMP–SMX has a moderate pill burden with three- to four-times daily dosing schedule. Patients unable to tolerate TMP–SMX are confronted with either parenteral therapy or other oral agents that may be less efficacious or are associated with potential serious adverse reactions. Pafuramidine (DB289) is an orally bioavailable prodrug of furamidine (DB75), an investigational diamidine that is less toxic than previous diamidines such as pentamidine. To date, human trials suggest that pafuramidine is well tolerated overall and has clinical activity against Pneumocystis pneumonia. In this article, we review the available data for the use of pafuramidine in Pneumocystis pneumonia.

Keywords::

• DB289
• diamidine
• pafuramidine
• Pneumocystis jiroveci

Financial & competing interests disclosure

This work was supported in part by the National Institute of Allergy and Infectious Diseases (NIAID) AIDS Clinical Trials Unit to New York University Grant AI-069532. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.