Chemoprophylaxis for Pneumocystis jirovecii pneumonia in cancer patients on corticosteroids
Author Information
Author(s): Worth L J, Dooley M J, Seymour J F, Mileshkin L, Slavin M A, Thursky K A
Primary Institution: Peter MacCallum Cancer Centre
Hypothesis
What is the frequency of chemoprophylaxis utilization against Pneumocystis jirovecii pneumonia in cancer patients receiving corticosteroid therapy?
Conclusion
The study found that fewer patients with solid tumors received prophylaxis compared to those with hematologic malignancies, indicating a need for improved prescribing practices.
Supporting Evidence
- 14 cases of PCP were identified, with no cases attributable to failed chemoprophylaxis.
- Only 3.9% of patients with solid tumors received prophylaxis compared to 63.6% of those with hematologic malignancy.
- The estimated incidence of PCP was 18 cases per 1000 patients receiving corticosteroid therapy.
Takeaway
Some cancer patients who take steroids can get a serious lung infection, but there are medicines that can help prevent it. This study looked at how many patients actually got those medicines.
Methodology
The study involved two retrospective reviews: one identified cases of PCP treated at the cancer center, and the other reviewed pharmacy records to estimate prophylaxis use among at-risk patients.
Potential Biases
Potential bias in prescribing practices and underreporting of prophylaxis use.
Limitations
The study may overestimate the incidence of PCP due to assumptions about hospital bed-days and the lack of data on community-based corticosteroid prescriptions.
Participant Demographics
73 patients receiving high-dose corticosteroid therapy, with 30% having hematologic malignancy and 70% having solid tumors.
Statistical Information
P-Value
p<0.0001
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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