How is pneumonia in immunocompromised patients treated?

Updated: Jan 07, 2019
  • Author: Julie B Zhao, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Empiric antimicrobial therapy based on most likely pathogens

In the case of PCP pneumonia, recommendations are for adjuvant corticosteroid therapy when a room air arterial blood gas pO2 is < 70, or if the A-a gradient is >35. In a recent double-blinded RCT in HIV-infected infants, early administration of prednisolone at 48 hours after clinical diagnosis of PJP significantly reduced mortality in hospital and 6 months after discharge. [60] New research suggests that the current guidelines of a 21-day therapy can safely be reduced to 14 days in 60% of moderate-to-severe HIV-PCP and 90% of moderate cases. [61]


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