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We describe a 54\u2010year\u2010old, human immunodeficiency virus\u2013positive man with a history of sulfonamide allergy who received treatment with pentamidine for <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia. After only the third dose of pentamidine, it was noted that the patient's heart rate had decreased to 48 beats\/minute. Subsequently, five episodes of Wenckebach (Mobitz type 1) heart block with a ventricular rate of 28 beats\/minute were observed on continuous cardiac telemetry. Serum electrolyte and creatinine levels remained within normal limits. Within 4 days of discontinuing the pentamidine, the patient's heart rate stabilized at 80 beats\/minute without further intervention. Clinicians should be vigilant when monitoring for cardiotoxicity in patients receiving pentamidine throughout the duration of therapy. In addition, they should continue to reserve its use for moderate\u2010to\u2010severe <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia for which trimethoprim\u2010sulfamethoxazole is ineffective or contraindicated.<\/jats:p>","DOI":"10.1592\/phco.2005.25.6.899","type":"journal-article","created":{"date-parts":[[2005,10,10]],"date-time":"2005-10-10T04:50:40Z","timestamp":1128919840000},"page":"899-903","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Early\u2010Onset Pentamidine\u2010Associated Second\u2010Degree Heart Block and Sinus Bradycardia: Case Report and Review of the Literature"],"prefix":"10.1002","volume":"25","author":[{"given":"Tony","family":"Antoniou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Gough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/24.5.854"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01647232"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90774-1"},{"key":"e_1_2_1_5_2","first-page":"173","article-title":"Torsades de pointes during intravenous pentamidine isethionate therapy","volume":"140","author":"Mitchell P","year":"1989","journal-title":"Can Med Assoc J"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6579.1101"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(92)91047-5"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199004000-00031"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.36.705"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00936.x"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(88)90092-7"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90380-J"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90603-F"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199324050-00004"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/157.5.985"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002809202601104"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5273(97)02968-9"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00184735"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)81912-2"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.2005.25.6.899","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.2005.25.6.899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:55:28Z","timestamp":1761054928000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.2005.25.6.899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,6]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2005,6]]}},"alternative-id":["10.1592\/phco.2005.25.6.899"],"URL":"https:\/\/doi.org\/10.1592\/phco.2005.25.6.899","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,6]]},"assertion":[{"value":"2012-01-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}