Pneumocystis jiroveci (carinii) pneumonia

Micro-organism

Pneumocystis jiroveci 

Notes
  • Refer to Infection Unit consultant.
  • Consider adding prednisolone 1mg/kg in severe cases (e.g. PO2 <8kPa). (BHIVA guidelines recommend 40mg twice daily for 5 days, 40mg daily for 5 days, then 20mg daily for 11 days.)
  • Send induced sputum or broncho-alveolar lavage for pneumocystis PCR and culture for mycobacteria, fungi and viruses.
  • Consider immune deficiency and testing for HIV.
First Line

IV Co-trimoxazole 120mg/kg/day (in severe cases)

or orally (non-severe) in 3 or 4 divided doses

 

In HIV patients reduce on day 4 to 90mg/kg/day for 18 days.

(in line with BHIVA guidelines) 

Second Line

Seek specialist advice from Infection Unit