Table 2. Proposed indications for chemoprophylaxis against Pneumocystis pneumonia.
| Indication | |
|---|---|
| General patients | Prednisone of at least 20 mg for >4 weeks if patient has underlying immunosuppressive disorder or COPD |
| Cancer | Receiving corticosteroids |
| Alemtuzumab during and for at least 2 months after treatment and CD4 >200 cells/mL | |
| Temozolomide and radiation therapy and until CD4 is >200 cells/mL | |
| Fludarabine and T-cell–depleting agent (e.g., cladribine) until CD4 >200 cells/mL | |
| ALL patients while receiving anti-leukemic therapy | |
| Connective tissue diseases | Granulomatosis with polyangiitis treated with cyclophosphamide especially if also receiving corticosteroids |
| Primary systemic vasculitis treated with corticosteroids and steroid-sparing agent (e.g., methotrexate) | |
| ANCA associated vasculitis treated with cyclophosphamide and corticosteroids | |
| Rheumatoid arthritis treated with TNF-α inhibitors especially if on corticosteroids or other intensive immunosuppression | |
| Connective tissue diseases treated with prednisolone >20 mg per day or equivalent doses of corticosteroid for more than 2 weeks | |
| Hematopoietic stem cell transplantation | Allogeneic stem cell recipients for at least 180 days |
| Autologous peripheral blood stem cell transplant recipients for 3–6 months after transplant | |
| All recipients for 6 months | |
| Recipients receiving immunosuppressive therapy or with chronic GVHD for >6 months or the duration of immunosuppression | |
| Solid organ transplantation | Solid organ transplant recipients for at least 6–12 months after transplant |
| Renal transplant recipients for a minimum of 4 months after transplantation | |
| Renal transplant recipients for 3–6 months after transplantation and at least 6 weeks during and after treatment for acute rejection | |
| Inflammatory bowel disease | Patients receiving TNF-α inhibitors especially if on corticosteroids or other intensive immunosuppression |
COPD: chronic obstructive pulmonary disease; ALL: acute lymphoid leukemia; ANCA: antineutrophil cytoplasmic antibody; GVHD: graft-versus-host disease; TNF-α: tumor necrosis factor-α.