An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital

Pneumocystis jirovecii pneumonia (PCP) is associated with high mortality in immunocompromised patients without human immunodeficiency virus infection. However, chemoprophylaxis is highly effective. In patients with solid tumours or haematologic malignancy, several risk factors for developing PCP hav...

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Bibliographic Details
Published in:	British journal of cancer 2005-03, Vol.92 (5), p.867-872
Main Authors:	WORTH, L. J, DOOLEY, M. J, SEYMOUR, J. F, MILESHKIN, L, SLAVIN, M. A, THURSKY, K. A
Format:	Article
Language:	eng
Subjects:	Adrenal Cortex Hormones - adverse effects Adrenal Cortex Hormones - therapeutic use Adult Aged Anti-Bacterial Agents - therapeutic use Biological and medical sciences Chemoprevention - methods Clinical Study Female Hematologic Neoplasms - drug therapy Humans Male Medical sciences Middle Aged Neoplasms - drug therapy Pneumocystis carinii Pneumocystis Infections - prevention & control Tumors
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Summary:	Pneumocystis jirovecii pneumonia (PCP) is associated with high mortality in immunocompromised patients without human immunodeficiency virus infection. However, chemoprophylaxis is highly effective. In patients with solid tumours or haematologic malignancy, several risk factors for developing PCP have been identified, predominantly corticosteroid therapy. The aims of this study were to identify the potentially preventable cases of PCP in patients receiving corticosteroid therapy at a tertiary care cancer centre and to estimate the frequency of utilisation of chemoprophylaxis in these patients. Two retrospective reviews were performed. Over a 10-year period, 14 cases of PCP were identified: no cases were attributable to failed chemoprophylaxis, drug allergy or intolerance. During a 6-month period, 73 patients received high-dose corticosteroid therapy (> or =25 mg prednisolone or > or =4 mg dexamethasone daily) for > or =4 weeks. Of these, 22 (30%) had haematologic malignancy, and 51 (70%) had solid tumours. Fewer patients with solid tumours received prophylaxis compared to patients with haematologic malignancy (3.9 vs 63.6%, P
ISSN:	0007-0920 1532-1827