TY - JOUR
T1 - Should prophylaxis for Pneumocystis carinii pneumonia in solid organ transplant recipients ever be discontinued?
AU - Gordon, Steven M.
AU - LaRosa, Steven P.
AU - Kalmadi, Sujith
AU - Arroliga, Alejandro C.
AU - Avery, Robin K.
AU - Truesdell-LaRosa, Laura
AU - Longworth, David L.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1999
Y1 - 1999
N2 - Solid organ transplant recipients are at risk for Pneumocystis carinii pneumonia (PCP), but the risk of PCP beyond 1 year is poorly defined. We identified 25 cases of PCP in 1,299 patients Undergoing solid organ transplantation between 1987 and 1996 at The Cleveland Clinic Foundation (4.8 cases per 1,000 person transplant-years [PTY]). Ten (36%) of 28 PCP cases (transplantation was performed before 1987 in three cases) occurred ≥ 1 year after transplantation, and no patient developed PCP while receiving prophylaxis for PCP. The incidence of PCP during the first year following transplantation was eight times higher than that during subsequent years. The highest rate occurred among lung transplant recipients (22 cases per 1,000 PTY), for whom the incidence did not decline beyond the first year of transplantation. We conclude that the incidence of PCP is highest during the first year after transplantation and differs by type of solid organ transplant. Extending the duration of PCP prophylaxis beyond I year may be warranted for lung transplant recipients.
AB - Solid organ transplant recipients are at risk for Pneumocystis carinii pneumonia (PCP), but the risk of PCP beyond 1 year is poorly defined. We identified 25 cases of PCP in 1,299 patients Undergoing solid organ transplantation between 1987 and 1996 at The Cleveland Clinic Foundation (4.8 cases per 1,000 person transplant-years [PTY]). Ten (36%) of 28 PCP cases (transplantation was performed before 1987 in three cases) occurred ≥ 1 year after transplantation, and no patient developed PCP while receiving prophylaxis for PCP. The incidence of PCP during the first year following transplantation was eight times higher than that during subsequent years. The highest rate occurred among lung transplant recipients (22 cases per 1,000 PTY), for whom the incidence did not decline beyond the first year of transplantation. We conclude that the incidence of PCP is highest during the first year after transplantation and differs by type of solid organ transplant. Extending the duration of PCP prophylaxis beyond I year may be warranted for lung transplant recipients.
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U2 - 10.1086/515126
DO - 10.1086/515126
M3 - Article
C2 - 10064238
AN - SCOPUS:0033010003
SN - 1058-4838
VL - 28
SP - 240
EP - 249
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 2
ER -