caa a22 4500 397590997 CHVBK 20180308164938.0 cr unu---uuuuu 161202e199605 xx s 000 0 eng 10.1093/jac/37.suppl_B.33 doi (NATIONALLICENCE)oxford-10.1093/jac/37.suppl_B.33 Pneumocystis carinii infection: current treatment and prevention [Elektronische Daten] [Robert F. Miller, Jo Le Noury, Elizabeth L. Corbett, J. Mark Felton, Kevin M. De Cock] Pneumocystis carinii is a common cause of pneumonia in individuals who are immunosuppressed by HIV infection. Use of molecular biological techniques show that P. carinii is a fungus and that infection in man is not a zoonosis. Invasive tests such as sputum induction or bronchoscopy are used to make the diagnosis of P. carinii pneumonia. Life long primary prophylaxis is given to HIV positive individuals with CD4+ lymphocyte counts <0.20 x 109/L or a CD4: total lymphocyte ratio of <1.5, constitutional symptoms, or with other AIDS defining diseases. Secondary prophylaxis is given after a first episode to prevent a recurrence. First choice for primary and secondary prophylaxis is oral co-trimoxazole 960 mg od or three times a week. In patients who are intolerant to co-trimoxazole, nebulised pentamidine or dapsone (with or without pyrimethamine) are second and third choices. In a patient with acute PCP disease, severity should be assessed using clinical, radiographic and blood gas criteria as those with moderate or severe disease will benefit from adjuvant glucocorticoids. Co-trimoxazole (120 mg/kg/day in divided doses for 21 days) is first choice therapy for PCP of all degrees of severity. In patients who fail to respond to co-trimoxazole or who are intolerant to it, second line treatment is iv pentamidine in those with severe disease and oral dapsone with trimethoprim, oral clindamycin with primaquine or iv pentamidine in those with mild or moderately severe disease. © 1996 The British Society for Antimicrobial Chemotherapy Articles nationallicence Miller Robert F. Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut Le Noury Jo Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut Corbett Elizabeth L. Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut Felton J. Mark Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut De Cock Kevin M. Department of Clinical Sciences, London School of Tropical Medicine and Hygiene, Camden and Islington Community Health Services NHS Trust Middlesex Hospital Site, London WIN 8AA, UK aut Journal of Antimicrobial Chemotherapy Oxford University Press 37(1996-05), 33-53 0305-7453 37<33 1996 37 jac https://doi.org/10.1093/jac/37.suppl_B.33 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jac/37.suppl_B.33 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Miller Robert F. Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut NATIONALLICENCE 700 1- Le Noury Jo Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut NATIONALLICENCE 700 1- Corbett Elizabeth L. Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut NATIONALLICENCE 700 1- Felton J. Mark Departments of Medicine Middlesex Hospital Site, London WIN 8AA, UK aut NATIONALLICENCE 700 1- De Cock Kevin M. Department of Clinical Sciences, London School of Tropical Medicine and Hygiene, Camden and Islington Community Health Services NHS Trust Middlesex Hospital Site, London WIN 8AA, UK aut NATIONALLICENCE 773 0- Journal of Antimicrobial Chemotherapy Oxford University Press 37(1996-05), 33-53 0305-7453 37<33 1996 37 jac Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford