Twice weekly prophylaxis with trimethoprim/sulfamethoxazole for Pneumocystis jirovecii pneumonia in pediatric oncology patients

被引:2
作者
Awad, Monica [1 ]
Sierra, Caroline M. [2 ]
Mesghali, Elhaam [3 ]
Bahjri, Khaled [1 ,4 ]
机构
[1] Sutter Med Ctr, Sacramento, CA USA
[2] Loma Linda Univ, Sch Pharm, Dept Pharm Practice, 24745 Stewart St, Loma Linda, CA 92350 USA
[3] Riverside Univ Hlth Syst, Moreno Valley, CA USA
[4] Loma Linda Univ, Sch Pharm, Dept Pharmaceut & Adm Sci, Loma Linda, CA 92350 USA
关键词
Antibiotic prophylaxis; pediatrics; neoplasms; pneumocystis pneumonia; trimethoprim-sulfamethoxazole;
D O I
10.1177/1078155220979046
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Current recommendations for prophylaxis of Pneumocystis jirovecii pneumonia in oncology patients include administration of trimethoprim/sulfamethoxazole (TMP/SMX) three times weekly or the same total weekly dose given daily. The primary objective of this study was to evaluate the efficacy of two consecutive days per week of TMP/SMX for prevention of Pneumocystis jirovecii pneumonia (PJP) in pediatric oncology patients. A retrospective cohort, single-center analysis was conducted in oncology patients 21 years and younger who received TMP/SMX for PJP prophylaxis between February 1, 2013 and July 31, 2017. Changes to the prophylaxis regimen were documented and analyzed. A total of 322 patients received TMP/SMX on two consecutive days per week for PJP prevention, of whom four had confirmed PJP (1.3%). Neutropenia was the most common reason for switching to alternative prophylaxis therapy (11.5%). Two consecutive prophylaxis days with TMP/SMX may be insufficient to prevent PJP in children with hematologic malignancies. Neutropenia remains a barrier for TMP/SMX use for PJP prophylaxis. Further studies to compare PJP incidence in children receiving alternative prophylaxis regimens should be considered.
引用
收藏
页码:1936 / 1939
页数:4
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