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

Johan Maertens 1 Simone Cesaro 2 Georg Maschmeyer 3 Hermann Einsele 4 J. Peter Donnelly 5 Alexandre Alanio 6, 7 Philippe M. Hauser 8 Katrien Lagrou 9 Willem J. G. Melchers 5 Jannik Helweg-Larsen 10 Olga Matos 11 Stéphane Bretagne 7, 12 Catherine Cordonnier 13
1 Department of Hematology
2 G.B. Rossi Hospital, Verona University
3 Medizinische Klinik, Hämatologie und Onkologie
4 JMU - Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne]
5 Radboud university [Nijmegen]
6 Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris]
7 Mycologie moléculaire
8 Lausanne University Hospital
9 KU Leuven - Catholic University of Leuven - Katholieke Universiteit Leuven
10 Rigshospitalet [Copenhagen]
11 IHMT - Instituto de Higiene e Medicina Tropical
12 CNRMA - Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire
13 Service d'hématologie clinique
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, \textgreater4 weeks of treatment with corticosteroids and well-defined primary immune deficiencies in children. Additional indications are proposed depending on the treatment regimen.
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Submitted on : Tuesday, November 29, 2016 - 4:20:10 PM
Last modification on : Wednesday, November 3, 2021 - 9:22:51 AM

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Johan Maertens, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J. Peter Donnelly, et al.. ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2016, 71 (9), pp.2397--2404. ⟨10.1093/jac/dkw157⟩. ⟨pasteur-01405235⟩

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