Do you routinely prescribe PCP prophylaxis for patients who will be on steroids long-term?

Topics: Hematologic Malignancies • Radiation Oncology • Medical Oncology

If so, what is your time threshold for when you'll start PCP prophylaxis--when you anticipate steroid courses greater than 1 week? 1 month? 3 months?

Answer from: Radiation Oncologist at Community Practice

Yes. This is something I don't think is emphasized enough given the ease of the intervention and seriousness of infection. In my first year of practice, I saw 3 fatal cases of PCP in patients that were receiving steroids from medical oncology without PCP prophylaxis. So I prescribe it for virtually ...

Comments

Radiation Oncologist at VCU Massey Cancer Center
Starting OTC Pepcid or similar for GI prophylaxis ...

Radiation Oncologist at Fox Chase Cancer Center
Yes. If more than 10 mg prednisone equivalent.&nbs...

Answer from: Medical Oncologist at Community Practice

Agreed. Another recommendation comes from the American Thoracic Society: recommendation for PCP prophylaxis during the time period of treatment with >20 mg/day of prednisone for longer than 1 month. Options are TMP-SMX one double-strength tablet daily or three times per week.

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