Other Topics In Antimicrobial Therapy Pneumocystis prophylaxis

The use of prophylaxis for Pneumocystis jiroveci (formerly P. carinii) pneumonia (PCP) has been most extensively studied in children with acute lym-phoblastic leukemia, who have an overall 21% risk of PCP without prophylaxis, and in whom risk depends on the intensity of maintenance therapy.37 PCP occurs in other leukemic patients as well. Prophylaxis with thrice weekly trimethoprim-sulfamethoxazole (TMP-SMX) is highly effective.37 Whereas the IDSA guidelines do not recommend TMP-SMX prophylaxis for all neutropenic patients, they do recommend such prophylaxis for all patients at high risk for PCP, whether neutropenic or not, including leukemic patients receiving steroid therapy.1 In addition, any patient with a prior episode of PCP should receive long-term secondary prophylaxis.

0 0

Post a comment