Treatment of Pneumocystis Pneumonia in AIDS

To the Editor: The use of glucocorticoids as adjunctive therapy of Pneumocystis carinii pneumonia remains a controversial subject. In his editorial (Oct. 15 issue),¹ Hughes failed to address the issue of glucocorticoids as a potential therapeutic intervention, whereas Allegra et al. (Oct. 15 issue),² in reporting their results with trimetrexate, referred to “high-dose corticosteroids” as experimental treatment of patients in whom conventional therapy fails. Discussion of any possible role for steroids as part of combination therapy seems warranted in the light of the seriousness of pneumocystis infections. Current treatment of pneumocystis pneumonia with trimethoprim–sulfamethoxazole or pentamidine yields disappointing results, with.