作者
Georg Maschmeyer, Jannik Helweg-Larsen, Livio Pagano, Christine Robin, Catherine Cordonnier, Peter Schellongowski
发表日期
2016/9/1
来源
Journal of Antimicrobial Chemotherapy
卷号
71
期号
9
页码范围
2405-2413
出版商
Oxford University Press
简介
The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice. In patients with documented intolerance to this regimen, the preferred alternative is the combination of primaquine plus clindamycin. Treatment success should be first evaluated after 1 week, and in case of clinical non-response, pulmonary CT scan and bronchoalveolar lavage should be repeated to look for secondary or co-infections. Treatment duration typically is 3 weeks and secondary anti …
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