Adjunctive glucocorticoid therapy for Pneumocystis jirovecii pneumonia in solid organ transplant recipients: A multicenter cohort, 2015-2020.

Details

Serval ID
serval:BIB_D83D710E76C1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adjunctive glucocorticoid therapy for Pneumocystis jirovecii pneumonia in solid organ transplant recipients: A multicenter cohort, 2015-2020.
Journal
American journal of transplantation
Author(s)
Hosseini-Moghaddam S.M., Kothari S., Humar A., Albasata H., Yetmar Z.A., Razonable R.R., Neofytos D., D'Asaro M., Boggian K., Hirzel C., Khanna N., Manuel O., Mueller N.J., Imlay H., Kabbani D., Tyagi V., Smibert O.C., Nasra M., Fontana L., Obeid K.M., Apostolopoulou A., Zhang S.X., Permpalung N., Alhatimi H., Silverman M.S., Guo H., Rogers B.A., MacKenzie E., Pisano J., Gioia F., Rapi L., Prasad GVR, Banegas M., Alonso C.D., Doss K., Rakita R.M., Fishman J.A.
ISSN
1600-6143 (Electronic)
ISSN-L
1600-6135
Publication state
Published
Issued date
04/2024
Peer-reviewed
Oui
Volume
24
Number
4
Pages
653-668
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Solid organ transplant recipients (SOTRs) frequently receive adjunctive glucocorticoid therapy (AGT) for Pneumocystis jirovecii pneumonia (PJP). This multicenter cohort of SOTRs with PJP admitted to 20 transplant centers in Canada, the United States, Europe, and Australia, was examined for whether AGT was associated with a lower rate of all-cause intensive care unit (ICU) admission, 90-day death, or a composite outcome (ICU admission or death). Of 172 SOTRs with PJP (median [IQR] age: 60 (51.5-67.0) years; 58 female [33.7%]), the ICU admission and death rates were 43.4%, and 20.8%, respectively. AGT was not associated with a reduced risk of ICU admission (adjusted odds ratio [aOR] [95% CI]: 0.49 [0.21-1.12]), death (aOR [95% CI]: 0.80 [0.30-2.17]), or the composite outcome (aOR [95% CI]: 0.97 [0.71-1.31]) in the propensity score-adjusted analysis. AGT was not significantly associated with at least 1 unit of the respiratory portion of the Sequential Organ Failure Assessment score improvement by day 5 (12/37 [32.4%] vs 39/111 [35.1%]; P = .78). We did not observe significant associations between AGT and ICU admission or death in SOTRs with PJP. Our findings should prompt a reevaluation of routine AGT administration in posttransplant PJP treatment and highlight the need for interventional studies.
Keywords
Pneumocystis jirovecii, pneumocystis pneumonia, solid organ transplantation, Pneumocystis pneumonia
Pubmed
Create date
23/11/2023 15:14
Last modification date
03/04/2024 7:08
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