替代性肺囊炎 肺炎 固体器官移植中的预防 固体器官移植
Kevin D He1, Linh Nguyen2,3, Maxwell Norris2,3
1Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
概括
固体器官移植 (SOT) 接受者的肺囊炎肺炎 (PJP) 的替代预防有风险和障碍. 在不良事件消失后,重新尝试trimethoprim-sulfamethoxazole (TMP-SMX) 通常是可行的.
科学领域:
- 移植医学 移植医学
- 预防传染病 预防传染病
- 药理学 药理学是指药理学的学科.
背景情况:
- 有限的数据支持在固体器官移植 (SOT) 接受者中使用阿托瓦昆或达普松进行肺囊炎肺炎 (PJP) 预防.
- 三甲-硫甲醇 (TMP-SMX) 是首选的药物,但有时也会使用替代药物.
研究的目的:
- 在SOT接受者中评估替代PJP预防的安全性和有效性.
- 确定启动和继续PJP预防的障碍.
主要方法:
- 对接受非TMP-SMX PJP预防的成年SOT接受者的回顾性队列研究.
- 包括有超过一年随访的患者.
主要成果:
- 34.9%的SOT接受者接受了其他PJP预防,主要是atovaquone.
- 从TMP-SMX切换的常见原因包括高血和白血病.
- 发生了突破性感染 (毒素,诺卡迪亚),但没有报告PJP病例. 障碍包括成本和事先授权.
结论:
- 替代PJP预防与风险和启动障碍有关.
- 大多数患者在不良事件消失后都能容忍TMP-SMX,这表明重新试验是可行的.
- 在临床上适当时,应考虑重新使用TMP-SMX进行挑战.
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