Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients

Clin Microbiol Rev. 2004 Oct;17(4):770-82, table of contents. doi: 10.1128/CMR.17.4.770-782.2004.

Abstract

Pneumocystis infection in humans was originally described in 1942. The organism was initially thought to be a protozoan, but more recent data suggest that it is more closely related to the fungi. Patients with cellular immune deficiencies are at risk for the development of symptomatic Pneumocystis infection. Populations at risk also include patients with hematologic and nonhematologic malignancies, hematopoietic stem cell transplant recipients, solid-organ recipients, and patients receiving immunosuppressive therapies for connective tissue disorders and vasculitides. Trimethoprim-sulfamethoxazole is the agent of choice for prophylaxis against Pneumocystis unless a clear contraindication is identified. Other options include pentamidine, dapsone, dapsone-pyrimethamine, and atovaquone. The risk for PCP varies based on individual immune defects, regional differences, and immunosuppressive regimens. Prophylactic strategies must be linked to an ongoing assessment of the patient's risk for disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / microbiology
  • AIDS-Related Opportunistic Infections / prevention & control*
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use*
  • Bone Marrow Transplantation / adverse effects*
  • Humans
  • Immunocompromised Host
  • Pentamidine / administration & dosage
  • Pentamidine / therapeutic use
  • Pneumocystis Infections / drug therapy
  • Pneumocystis Infections / etiology
  • Pneumocystis Infections / prevention & control*
  • Sulfamethoxazole / administration & dosage
  • Sulfamethoxazole / adverse effects
  • Survival Rate
  • Trimethoprim / administration & dosage
  • Trimethoprim / adverse effects

Substances

  • Antifungal Agents
  • Pentamidine
  • Trimethoprim
  • Sulfamethoxazole