Pneumocystis Pneumonia: Epidemiology and Options for Prophylaxis in Non-HIV Immunocompromised Pediatric Patients

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• 作者：Salwa E. Sulieman (1) (2)
  Talene A. Metjian (3)
  Theoklis E. Zaoutis (2) (4)
  Brian T. Fisher (2) (4) (5)
  
• 关键词：Pneumocystis ; Pediatrics ; Prophylaxis ; Opportunistic infection
• 刊名：Current Fungal Infection Reports
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：8
• 期：1
• 页码：45-55
• 全文大小：404 KB
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• 作者单位：Salwa E. Sulieman (1) (2)
  Talene A. Metjian (3)
  Theoklis E. Zaoutis (2) (4)
  Brian T. Fisher (2) (4) (5)
  
  1. Division of Infectious Diseases, The Children鈥檚 Hospital of Philadelphia, 3615 Civic Center Boulevard, Abramson Research Center, Room 1202聽F, Philadelphia, PA, 19104, USA
  2. Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  3. Department of Antimicrobial Stewardship, The Children鈥檚 Hospital of Philadelphia, Philadelphia, PA, USA
  4. Division of Infectious Diseases and the Center for Pediatric Clinical Effectiveness, The Children鈥檚 Hospital of Philadelphia, Philadelphia, PA, USA
  5. Division of Infectious Diseases, The Children鈥檚 Hospital of Philadelphia, CHOP North, Suite 1515, Philadelphia, PA, 19104, USA
  
• ISSN：1936-377X

文摘

The pediatric population of non-HIV immunocompromised patients at risk for Pneumocystis pneumonia (PCP) continues to increase. While prophylactic therapy can be highly effective in preventing this opportunistic pathogen, identifying the at-risk populations appropriate for use of prophylaxis and navigating the risks and benefits of each therapeutic option can be challenging. In this article, the available epidemiology for baseline rates of PCP is presented for a variety of non-HIV immunocompromised pediatric populations. Additionally, the comparative effectiveness and side effect profiles for trimethoprim/sulfamethoxazole, dapsone, atovaquone, and pentamidine are discussed. Institutions are encouraged to review the data and to establish and implement a local practice guideline for PCP prophylaxis that can be monitored for effectiveness over time. An example of a standardized practice guideline is suggested.