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Prophylaxis With Trimethoprim/Sulfamethoxazole Is Not Necessary in Children With Solid Tumors Treated With Low-medium

Cristina Meazza1, Federica Galaverna2, Maria Grazia Petris3

  • 1From the Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.

The Pediatric Infectious Disease Journal
|March 12, 2021
PubMed

Insights

Trimethoprim/sulfamethoxazole prophylaxis for Pneumocystis jiroveci pneumonia (PJP) is standard for hematologic cancers but debated for solid tumors. A study found no PJP cases in children with solid tumors who did not receive prophylaxis.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Pharmacology

Background:

  • Pneumocystis jiroveci pneumonia (PJP) prophylaxis with trimethoprim/sulfamethoxazole is established for pediatric hematologic malignancies.
  • The role of PJP prophylaxis in pediatric solid tumor patients remains under investigation and is subject to clinical debate.

Purpose of the Study:

  • To evaluate the necessity and safety of PJP prophylaxis in pediatric patients diagnosed with solid tumors.
  • To analyze the incidence of PJP in solid tumor patients who did not receive prophylactic treatment.

Main Methods:

  • A retrospective study was conducted across 16 centers belonging to the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP).
  • Data were collected on 2863 pediatric patients with solid tumors, specifically examining prophylaxis status and PJP occurrence.
  • A cohort of 1046 patients who did not receive PJP prophylaxis was identified and analyzed.

Main Results:

  • No cases of Pneumocystis jiroveci pneumonia (PJP) were reported among the 1046 pediatric solid tumor patients who did not receive trimethoprim/sulfamethoxazole prophylaxis.
  • The study observed a zero incidence rate of PJP in this specific patient group during the study period.

Conclusions:

  • The findings suggest that PJP prophylaxis may not be necessary for all pediatric patients with solid tumors.
  • Further research could refine guidelines regarding PJP prophylaxis in pediatric oncology, potentially sparing patients unnecessary medication and associated risks.

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