Bronchodilator Pretreatment Improves Aerosol Deposition Uniformity in HIV-Positive Patients Who Cough While Inhaling Aerosolized Pentamidine

Objective: To determine the effect of bronchodilator pretreatment on deposition uniformity of aerosolized pentamidine (AP) in HIV-positive patients who coughed while inhaling AP. Design: Nonrandomized control trial. Setting: A university hospital. Patients: Ten HIV-positive patients who were using AP prophylactically. Intervention: Four patients who coughed during AP administration were pretreated with 10 mg metaproterenol aerosol prior to a second inhalation of AP. Measurements: Skew, a measure of overall deposition symmetry, deposition in the apex vs the base of the right lung (A:B ratio), and percentage of change from baseline in peak expiratory flow rate (PEFR). Results: At baseline, the average (± SD) skew value for four subjects who coughed (0.89 ± 0.19) was significantly higher than for six control subjects (0.58 ± 0.07) (p