ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

Johan Maertens, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J. Peter Donnelly, Alexandre Alanio, Philippe M. Hauser, Katrien Lagrou, Willem J.G. Melchers, Jannik Helweg-Larsen, Olga Matos, Stéphane Bretagne, Catherine Cordonnier, Samir Agrawal, Christopher Kibbler, Antonio Pagliuca, Katherine Ward, Murat Akova, Raoul Herbrecht, Vincent MalletPatricia Ribaud, Mahmoud Aljurf, Dina Averbuch, Dan Engelhard, Thomas Berg, Oliver Cornely, Olaf Penack, Florian van Boemmel, Marie von Lilienfeld-Toal, Ola Blennow, Per Ljungman, Roger Bruggemann, Peter Donnelly, Bart Jan Kullberg, Willem Melchers, Thierry Calandra, Hans Hirsch, Oscar Marchetti, Christina Orasch, Frederic Tissot, Elio Castagnola, Corrado Girmenia, Malgorzata Mikulska, Livio Pagano, Claudio Viscoli, Rafael De La Camara, Rafael Duarte, Patricia Munoz, Lubos Drgona, Ruth Hargreaves, Petr Hubacek, Michal Kouba, Zdenek Racil, Galina Klyasova, George Pettrikos, Emmanuel Roilides, Anna Skiada, Valérie Rizzi-Puechal, Janos Sinko, Monica Slavin, Jan Styczynski, Lorraine Tweddle, Craig Wood

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209 Citations (Scopus)

Abstract

The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults (A-II) and children (A-I) and should be given during the entire period at risk. Recent data indicate that children may benefit equally from a once-weekly regimen (B-II). All other drugs, including pentamidine, atovaquone and dapsone, are considered second-line alternatives when trimethoprim/ sulfamethoxazole is poorly tolerated or contraindicated. The main indications of PCP prophylaxis are ALL, allogeneic HSCT, treatment with alemtuzumab, fludarabine/cyclophosphamide/rituximab combinations, >4 weeks of treatmentwith corticosteroids andwell-defined primary immune deficiencies in children. Additional indications are proposed depending on the treatment regimen.

Original languageEnglish
Pages (from-to)2397-2404
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number9
DOIs
Publication statusPublished - 1 Sept 2016

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