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1-Minute Consult

When should I give corticosteroids to my patient with Pneumocystis pneumonia?

Simran Gupta, MD and Lisa M. Bebell, MD, MSc, FIDSA
Cleveland Clinic Journal of Medicine April 2024, 91 (4) 217-219; DOI: https://doi.org/10.3949/ccjm.91a.23082
Simran Gupta
Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
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Lisa M. Bebell
Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
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    TABLE 1

    Recommendations for adjunctive corticosteroids in patients with Pneumocystis pneumonia

    Patient populationRecommendation
    HIV-positive WITH baseline hypoxemiaStrong recommendation that adjunctive corticosteroids improve outcomes with Pneumocystis jirovecii pneumonia treatment
    HIV-positive WITHOUT baseline hypoxemiaSteroids should be considered if respiratory status worsens after Pneumocystis jirovecii pneumonia treatment is started
    HIV-negative WITH hypoxemia or respiratory failureSteroids should be considered—evidence is unclear
    HIV-negative WITH mild to moderate respiratory diseaseSteroids should not be given routinely and may result in worse outcomes
    • HIV = human immunodeficiency virus

    • Based on information in references 5–13.

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Cleveland Clinic Journal of Medicine: 91 (4)
Cleveland Clinic Journal of Medicine
Vol. 91, Issue 4
1 Apr 2024
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When should I give corticosteroids to my patient with Pneumocystis pneumonia?
Simran Gupta, Lisa M. Bebell
Cleveland Clinic Journal of Medicine Apr 2024, 91 (4) 217-219; DOI: 10.3949/ccjm.91a.23082

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When should I give corticosteroids to my patient with Pneumocystis pneumonia?
Simran Gupta, Lisa M. Bebell
Cleveland Clinic Journal of Medicine Apr 2024, 91 (4) 217-219; DOI: 10.3949/ccjm.91a.23082
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    • WHEN SHOULD YOU SUSPECT PJP?
    • SEVERITY OF DISEASE
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    • WHAT IS THE EVIDENCE FOR CORTICOSTEROIDS?
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