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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