Pneumocystis pneumonia treatment

Acute pneumonia caused by Pneumocystis jirovecii in immunocompromised patients. High-dose co-trimoxazole is the drug of choice; adjunctive glucocorticoids are added in severe disease.

ICD-10 B591 drug

Also known as: PJP treatment, PCP treatment

Drugs used for this condition

ACo-trimoxazoleFirst line · Sulfonamide-trimethoprim combinationCo-trimoxazole at 15–20 mg/kg/day by trimethoprim, divided into 3–4 doses, for 21 days is the first-line treatment of Pneumocystis pneumonia. CDC/NIH/IDSA 2024 recommend this regimen for both HIV-associated PJP and non-HIV patients. With PaO2 below 70 mm Hg or alveolar-arterial gradient above 35 mm Hg, prednisolone 40 mg twice daily is added. Alternatives for intolerance include pentamidine and primaquine plus clindamycin.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit