II. Indications: Start prophylaxis
- CD4 Count < 200
- Constitutional symptoms regardless of CD4 Count
- Oral Candidiasis (Thrush)
- Unexplained fever > 2 weeks
- Prior history of Pneumocystis
- Second episode PCP Pneumonia within 1 year: 30-60%
III. Indications: Stop prophylaxis
- CD4 Count > 200 (stable for at least 3 months) and
- Triple Antiretroviral therapy >6 months
- Also applies to MAC, Cryptococcus, Toxoplasmosis
- References
IV. Efficacy
- Bactrim daily is extremely effective in preventing PCP
- Also decreases the Incidence of Bacterial Infections
- Decreases the Incidence of ToxoplasmosisEncephalitis
- Patients with previous Toxoplasmosis infection
V. Dosing: First line
VI. Dosing: Other agents
-
Aerosolized Pentamidine
- Adults: 300 mg every 4 weeks reduces the risk of PCP by 60-80%
- Well tolerated (cough and bronchospasm in 50% of patients)
-
Dapsone 100 mg PO qd
- Add Pyrimethamine for Toxoplasmosis coverage
- Screen for G6PD prior to use
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Concepts | Therapeutic or Preventive Procedure (T061) |
English | Pneumocystis carinii prophylaxis, Pneumocystis jirovecii prophylaxis |
Dutch | pneumocystis carinii-profylaxe, profylaxe tegen Pneumocystis jiroveci |
French | Prophylaxie anti-pneumocystis carinii, Prophylaxie anti-Pneumocystis jirovecii |
German | Pneumocystis carinii Prophylaxe, Pneumocystis jirovecii-Prophylaxe |
Italian | Profilassi per Pneumocystis carinii, Profilassi per Pneumocystis jirovecii |
Portuguese | Profilaxia de Pneumocystis carinii, Profilaxia de Pneumocystis jirovecii |
Spanish | Profilaxis frente al Pneumocystis carinii, Profilaxis frente al Pneumocystis jirovecii |
Japanese | ニューモシスティスカリニ感染予防, ニューモシスティスカリニカンセンヨボウ, ニューモシスチス・イロベチイ感染予防, ニューモシスチスイロベチイカンセンヨボウ |
Czech | Prevence pneumocystózy, Profylaxe proti infekci způsobené Pneumocystis jirovecii |
Hungarian | Pneumocystis carinii profilaxis, Pneumocystis jirovecii prophylaxis |