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实体瘤患儿耶氏肺孢子菌肺炎(PJP)预防指南

Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children With Solid Tumors.

作者信息

Proudfoot Rebecca, Phillips Bob, Wilne Sophie

机构信息

*Department of Paediatrics, John Radcliffe Hospital, Oxford †Centre for Reviews and Dissemination, University of York, York ‡Paediatric Oncology Department, University Hospitals Nottingham NHS Trust, Queen's Medical Centre, Nottingham, UK.

出版信息

J Pediatr Hematol Oncol. 2017 Apr;39(3):194-202. doi: 10.1097/MPH.0000000000000771.

Abstract

Although it is well-established that children undergoing allogeneic stem cell transplants and treatment for leukemia should be offered prophylaxis against Pneumocystis jirovecii pneumonia, the risk for children with solid malignancies is less certain. This guideline has been developed with the aim of standardizing practice and optimizing the benefit versus risk of prophylactic medication in this group of patients. P. jirovecii pneumonia has a high mortality rate even with prompt antimicrobial treatment. Since prophylaxis with co-trimoxazole is safe, effective, and inexpensive, we suggest that all children with malignancies undergoing immunosuppressive therapy are offered prophylaxis unless there are clear contraindications.

摘要

虽然对于接受异基因干细胞移植和白血病治疗的儿童,应给予预防卡氏肺孢子虫肺炎的措施这一点已得到充分证实,但实体恶性肿瘤患儿的感染风险尚不确定。制定本指南的目的是规范实践,并优化该组患者预防性用药的获益与风险。即使及时进行抗菌治疗,卡氏肺孢子虫肺炎的死亡率仍很高。由于复方新诺明预防安全、有效且价格低廉,我们建议,除非有明确的禁忌证,所有接受免疫抑制治疗的恶性肿瘤患儿均应给予预防措施。

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