|Title:||PCP Prophylaxis in Patients with Interstitial Lung Disease (ILD) on Steroids And/or other Immunosuppressive Medication|
|Author(s):||M. O’Callaghan Y. Ibrahim L. Fox J. Stack K.MA. O’Reilly|
|Institution:||Mater Misericordiae University Hospital|
|Poster:||Click to view poster|
|Abstract:||References: 1. doi:10.1002/14651858.CD005590.pub3|
Abstract (n= 200):
Infection with pneumocystis jirovecii is a significant cause of morbidity and mortality in immunocompromised patients. The most common manifestation is Pneumocystis pneumonia (PCP). (1) There are no international guidelines guiding PCP prophylaxis in patients with interstitial lung disease (ILD) requiring immunosuppressive therapy. However, prophylaxis is widely recommended in clinical practice.
The audit was a single-centre study looking at patients attending the specialist ILD clinic who were prescribed immunosuppressive therapy. Anonymous data was collected via the electronic healthcare record. Our data collection tool was pre-defined in conjunction with the rheumatology service.
19 patients were included. 8 patients had connective tissue disease-associated ILD (42%). 11 patients were prescribed dual immunosuppressive agents and five patients were prescribed triple therapy. 84% of patients were prescribed prednisolone (n=16). 3 of the 19 patients were prescribed PCP prophylaxis (15.7%) and in all cases, co-trimoxazole was the drug of choice. The dose given varied across all three patients.
PCP prophylaxis prescribing was exceptionally low. In the absence of international guidance, we created a simple prescribing flowsheet for PCP prophylaxis .This will help guide physicians which patients should be considered for PCP prophylaxis and the appropriate doses. We will follow up with a re-audit of our practice.