【医脉通】2017+儿童实体肿瘤患者卡氏肺囊虫肺炎的预防指南.pdf

ORIGINAL ARTICLE Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children With Solid Tumors Rebecca Proudfoot, MA Oxon, MB BS, MRCPCH, PGDip PID Oxon,* Bob Phillips, BM BCh, MA, PhD,w and Sophie Wilne, MA Cantab, MB BS, MDz immunodeficiency syndrome.5,6 Even with prompt anti- Summary: Although it is well-established that children undergoing microbial treatment, PJP has a high mortality rate7 but allogeneic stem cell transplants and treatment for leukemia should prophylaxis with co-trimoxazole is safe, effective, and be offered prophylaxis against Pneumocystis jirovecii pneumonia, inexpensive.8 the risk for children with solid malignancies is less certain. This With the implementation of antiretroviral therapy and guideline has been developed with the aim of standardizing practice and optimizing the benefit versus risk of prophylactic medication in PJP prophylaxis the incidence of PJP associated with the this group of patients. P. jirovecii pneumonia has a high mortality human immunodeficiency virus (HIV) has sharply rate even with prompt antimicrobial treatment. Since prophylaxis declined,9 whereas that associated with treatment for with co-trimoxazole is safe, effective, and inexpensive, we suggest malignancy in non-HIV infected hosts has increased.10,11 that all children with malignancies undergoing immunosuppressive Before the routine use of prophylaxis, Hughes et al12,13 therapy are offered prophylaxis