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Why are steroids used in PJP?
Answer. Corticosteroids are used as adjunctive initial therapy only in patients with HIV infection who have severe P jiroveci pneumonia (PJP) as defined by a room air arterial oxygen pressure of less than 70 mm Hg or an arterial-alveolar O2 gradient that exceeds 35 mm Hg.
How is PCP pneumonia treated?
PCP must be treated with prescription medicine. Without treatment, PCP can cause death. The most common form of treatment is trimethoprim/sulfamethoxazole (TMP/SMX), which is also known as co-trimoxazole and by several different brand names, including Bactrim, Septra, and Cotrim.
When do you give PJP prophylaxis?
For recipients of solid organ transplant, guidelines recommend primary prophylaxis for a minimum of 6 months after transplant. Some patients, such as lung and small bowel transplant recipients or those with a history of PCP infection or chronic cytomegalovirus infection, have indications for lifelong prophylaxis.
When do you stop PJP prophylaxis?
There is no consensus regarding when to stop secondary prophylaxis. Some investigators suggest that therapy can be stopped if CD4 count increases to >200 to 350 cells/mm3 for 3 to 6 months in response to ART, but others suggest that therapy should be continued indefinitely.
What is the preferred regimen for primary prophylaxis of Pneumocystis pneumonia?
Trimethoprim-sulfamethoxazole (TMP-SMX) is the recommended prophylactic agent for PCP (AI). One double-strength TMP-SMX tablet daily is the preferred regimen (AI), but one single-strength tablet daily45 is also effective and may be better tolerated than the double-strength tablet (AI).