PROPHYLAXIS FOR PNEUMOCYSTIS PNEUMONIA
PROPHYLAXIS FOR PNEUMOCYSTIS PNEUMONIA
Pneumocystis pneumonia is a fungal infection caused by Pneumocystis jiroveci (previously known as Pneumocystis carinii and therefore commonly referred
to still as PCP). Patients with impaired cell-mediated immunity are at a higher risk of developing this infection e.g. immunosuppressed HIV patients, stem
cell transplant, solid organ transplant, cancer patients (particularly haematological malignancies) and patients on immunosuppressive medications.
A report published in 2013 from Public Health England investigated the anecdotal reports of increasing PCP infections and results confirmed that diagnoses
of PCP had increased by an average of 7% per year for the period 2000-2010 in non HIV patients. An association was found between PCP and a variety of
chronic lung diseases and on the basis of this data, the authors propose pre-existing lung disease as a new PCP risk category. A Cochrane review
recommends prophylaxis for patients with haematological malignancies and for recipients of bone marrow transplant and solid organ transplants.
The NHS Tayside Antimicrobial Management Group has agreed it would be useful to have a consistent local approach to PCP prophylaxis. This document
summarises the clinical situations where there is good evidence to prescribe PCP prophylaxis and also indications where evidence and national guidance is
lacking.
Clinical Situation
HIV patients
Prophylaxis currently recommended
Recommended if CD4 ................
................
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