Evidence map›Paper›PMID 40234819›Full record

Observational studyBMC infectious diseases2025

Association of time-to-treatment with prognosis in pneumocystis pneumonia among immunocompromised patients without HIV infection: a multi-center, retrospective observational cohort study.

Haruka Fujioka, Hiroki Matsui, Yuya Homma, Tatsuya Nagai, Ayumu Otsuki, Hiroyuki Ito, Shinichiro Ohmura, Toshiaki Miyamoto, Daisuke Shichi, Watari Tomohisa and 2 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Immune Responses toJournal of inflammation research · 2026
    Review
  3. Clinical characteristics ofJournal of thoracic disease · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Haruka FujiokaDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan.
Hiroki MatsuiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Yuya HommaDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan.
Tatsuya NagaiDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan.
Ayumu OtsukiDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan.
Hiroyuki ItoDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan.
Shinichiro OhmuraDepartment of Rheumatology, Seirei Hamamatsu General Hospital, Aichi, Japan.
Toshiaki MiyamotoDepartment of Rheumatology, Seirei Hamamatsu General Hospital, Aichi, Japan.
Daisuke ShichiDepartment of Infection and Rheumatology, Seirei Mikatahara General Hospital, Shizuoka, Japan.
Watari TomohisaDepartment of Clinical Laboratory, Kameda Medical Center, Chiba, Japan.
Yoshihito OtsukaDepartment of Clinical Laboratory, Kameda Medical Center, Chiba, Japan.
Kei NakashimaDepartment of Pulmonology, Kameda Medical Center, Chiba, Japan. kei.7.nakashima@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPneumocystis jirovecii pneumonia (PCP) in non-human immunodeficiency virus (HIV) patients is associated with high morbidity and mortality. Although prior studies have linked delayed treatment to worse outcomes, they are often limited by small sample sizes and inadequate adjustment for confounders. Therefore, we evaluated whether early treatment after hospital admission improves mortality in non-HIV PCP, adjusting for patient characteristics.

methodsThis multi-center, retrospective, observational cohort study included non-HIV PCP patients treated between January 2006 and March 2021 at three institutions. Participants were divided into the early treatment (initiated within 2 days) and late treatment (initiated between days 3 and 7) groups. The primary endpoint was 30-day mortality, and the secondary endpoints were 180-day mortality. Propensity score weighting was used to adjust for patient background.

resultsNinety-four patients in the early treatment group and 43 in the late treatment group were evaluated. The average time-to-treatment for the early and late treatment groups was 0.13 days and 3.63 days, respectively. After adjusting for patient characteristics, there were no significant differences in 30-day mortality (14.0% vs. 8.2%, p = 0.307) or 180-day mortality (21.5% vs. 17.7%, p = 0.600) between the early and late treatment groups. In a subgroup analysis of cases requiring oxygen supplementation, 30-day and 180-day mortality also showed no significant differences between the two groups.

conclusionThis study emphasizes the importance of accurate diagnosis and tailored management based on disease severity rather than immediate empirical treatment, as early treatment initiation was not significantly associated with 30-day or 180-day mortality in non-HIV PCP.

Indexed as

Immunocompromised HostPneumonia, PneumocystisTime-to-TreatmentAdultAgedFemaleHIV InfectionsHumansMaleMiddle AgedPneumocystis cariniiPrognosisRetrospective StudiesNon-human immunodeficiency virus-infected patientPneumocystis pneumoniaPrognosisTime-to-treatment

Identifiers

PMID40234819
PMCPMC12001674

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.