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Pneumocystis pneumonia (PCP) prophylaxis is effective in HIV-positive patients and other immunosuppressed groups, but consensus is lacking on PCP prophylaxis in patients with rheumatic diseases. In this study, researchers identified 1092 Korean patients with rheumatic diseases who were treated with high-dose steroids (prednisone equivalent, ≥30 mg daily) for longer than 4 weeks. Patients were divided into PCP prophylaxis and control groups based on whether they also received prophylactic trimethoprim-sulfamethoxazole (TMP-SMX), and propensity-score matching created two groups of 235 patients each.
During 1464 person-years, 30 PCP cases occurred, with 37% mortality; only 1 (nonfatal) PCP case occurred among prophylaxis patients. TMP-SMX lower…