ArticleSeminars in arthritis and rheumatism2019
Pneumocystis jirovecii pneumonia (PJP) prophylaxis patterns among patients with rheumatic diseases receiving high-risk immunosuppressant drugs.
Article in Seminars in arthritis and rheumatism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- II Brazilian Society of Rheumatology consensus for lupus nephritis diagnosis and treatment.Advances in rheumatology (London, England) · 2024Guideline
- Pooled it
- Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization inInternational journal of environmental research and public health · 2022Pooled it
- Is cotrimoxazole prophylaxis against Pneumocystis jirovecii pneumonia needed in patients with systemic autoimmune rheumatic diseases requiring immunosuppressive therapies?Rheumatology international · 2021Pooled it
- Pooled it
- Article
- From Genotype to Functional Risk: A Multi-Omic Approach to Predicting Thiopurine and Methotrexate Co-Therapy-Induced Liver Injury.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Trimethoprim sulfamethoxazole prophylaxis and serious infections in granulomatosis with polyangiitis treated with rituximab.Rheumatology (Oxford, England) · 2025Article
- Providing care for kidney transplant recipients: An overview for generalists.World journal of nephrology · 2025Review
- Abrupt Breathlessness: Pneumocystis jirovecii Pneumonia Associated with Inebilizumab in Neuromyelitis Optica Spectrum Disorder: A Case Report and Literature Review.Infection and drug resistance · 2025Article
- Hospitalised infections and rituximab administration among children and adolescents with systemic lupus erythematosus from 2009 to 2021.Lupus science & medicine · 2024Article
- Pneumocystis pneumonia in intensive care: clinical spectrum, prophylaxis patterns, antibiotic treatment delay impact, and role of corticosteroids. A French multicentre prospective cohort study.Intensive care medicine · 2024Observational
- Pneumocystis pneumonia in French intensive care units in 2013-2019: mortality and immunocompromised conditions.Annals of intensive care · 2024Article
- Incidence of Pneumocystis Jiroveci Pneumonia in Patients With ANCA-Associated Vasculitis Initiating Therapy With Rituximab or Cyclophosphamide.Arthritis care & research · 2024Article
- Pneumocystis jirovecii pneumonia increases the 3-months mortality of anti-MDA5-antibody-positive dermatomyositis patients.Frontiers in immunology · 2024Observational
- Antibiotic prophylaxis in immunosuppressed patients - Missed opportunities from trimethoprim-sulfamethoxazole allergy label.The World Allergy Organization journal · 2024Review
- Article
- Weighing the Risks and Benefits of Pneumocystis Jirovecii Pneumonia Prophylaxis in Rituximab Users.Arthritis & rheumatology (Hoboken, N.J.) · 2023Article
- Position statement on infection screening, prophylaxis, and vaccination in pediatric patients with rheumatic diseases and immunosuppressive therapies, part 2: infection prophylaxis.European journal of pediatrics · 2023Article
- Trimethoprim-sulfamethoxazole prophylaxis during treatment of granulomatosis with polyangiitis with rituximab in the United States of America: a retrospective cohort study.Arthritis research & therapy · 2023Article
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11 authors.
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Abstract
INTRODUCTION/
objectivesPneumocystis jirovecii pneumonia (PJP) is a rare but potentially fatal opportunistic infection; however, consensus varies around which conditions or medications confer a level of risk sufficient to justify antibiotic prophylaxis for PJP. We used electronic health record (EHR) data to assess the current patterns of PJP prophylaxis, PJP outcomes, and prophylaxis-related adverse events among patients with rheumatic diseases who were receiving high-risk immunosuppressant drugs.
methodsData derive from the EHR of a large health system. We included new immunosuppressant users with diagnoses of vasculitis, myositis, or systemic lupus erythematosus. We calculated the proportion of patients who received PJP prophylaxis for each diagnosis and drug combination. We also calculated the number of PJP infections and the number of antibiotic adverse drug events (ADEs) per patient-year of exposure.
resultsWe followed 316 patients for 23.2 + /- 14.2 months. Overall, 124 (39%) of patients received prophylactic antibiotics for PJP. At least 25% of patients with the highest risk conditions (e.g. vasculitis) or highest risk immunosuppressants (e.g. cyclophosphamide) did not receive PJP prophylaxis. We found no cases of PJP infection over 640 patient-years of follow up, including among those not receiving prophylaxis, and an overall incidence rate of ADEs of 2.2% per patient-year.
conclusionsPJP prophylaxis for patients with rheumatic conditions is inconsistent, with one quarter of patients who have high risk conditions or high risk immunosuppressants not receiving prophylaxis. However, given extremely low rates of PJP infection, but detectable ADEs to prophylactic antibiotics, our findings suggest that evidence to guide more personalized risk assessments are needed to inform PJP prophylaxis.
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