When should I take steroids for PCP pneumonia?

When should I take steroids for PCP pneumonia?

In adults, it is recommended to start the corticosteroid treatment as early as possible but within 72 hours after starting the PCP‐specific therapy.

Is PCP treated with steroids?

The use of adjunctive corticosteroids in the treatment of patients with moderate to severe PCP has resulted in a significant improvement in the development of respiratory failure and mortality. Past studies have demonstrated no clinical benefit in patients with mild disease (pO2>75 torr on room air).

When do you start PCP prophylaxis on steroids?

However, the American Thoracic Society provides a low evidence-based recommendation to consider PCP prophylaxis during the time period of treatment with >20 mg/day of prednisone for longer than 1 month.

When do you start PPX PCP?

Primary prophylaxis for Pneumocystis jirovecii pneumonia (PCP) should be initiated when the patient’s CD4 count <200cells/microL, CD4% is <14%, and patients have a detectable viral load.

How can PJP be prevented?

TMP-SMX is the agent of choice for PJP prophylaxis in the absence of a contraindication. In patients who cannot tolerate TMP-SMX, other options include dapsone, dapsone plus pyrimethamine, atovaquone, and aerosolized pentamidine. Commonly used prophylactic regimens are discussed below.

How long does it take to recover from PJP?

Treatment of extrapulmonary manifestations of PJP is the same as that for other pneumonias. In patients without HIV infection, response to treatment should begin within 4-5 days. In patients infected with HIV, the treatment response typically takes longer but should occur within the first 8 days.

How is PJP treated?

While officially classified as a fungal pneumonia, P jiroveci pneumonia (PJP) does not respond to antifungal treatment. The treatment of choice is TMP-SMX, with second-line agents including pentamidine, dapsone (often in combination with pyrimethamine), or atovaquone.

Is PJP curable?

PJP infection can be serious, but many people can be treated at home with antibiotics such as Bactrim (trimethoprim and sulfamethoxazole). There are also different alternative therapies such as atovaquone, dapsone, primaquine w/ clindamycin, and pentamidine.