Prophylaxis and post-treatment suppression
- PCP prophylaxis recommended for:
- HIV patients with CD4 < 200 cells/mm3 (0.2 x 109/L) or <14% or history of oropharyngeal candidiasis or AIDS-defining illness
- solid organ or stem cell transplant in past 12 months.
- Consider PCP prophylaxis for other patients with prolonged high dose corticosteroids (> 20mg/day prednisone or equivalent for > 4 weeks)/TNF inhibitors/immunosuppression.
- TMP/SMX also provides prophylaxis of some bacterial infections.
Usual Pathogens
Pneumocystis jirovecii
| Empiric Therapy | Dose | Duration |
|---|---|---|
| TMP/SMX | 1 DS tab PO daily or | chronic |
| 1 SS tab PO daily | chronic |
Alternative
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Dapsone | 100mg PO daily | chronic |
| or | ||
| [Dapsone | 200mg PO once per week | chronic |
| + | ||
| Pyrimethamine | 75mg once per week | |
| + | ||
| Leucovorin (Folinic acid)] | 25mg once per week | |
| or | ||
| Atovaquone | 1500mg PO daily with food | chronic |
| or | ||
| Pentamidine | 300mg in 6mL SWI by aerosol every 4 weeks | chronic |