Is Adjunctive Glucocorticoid Therapy Beneficial in Solid Organ Transplant Recipients with Pneumocystis jirovecii Pneumonia?

Adjunctive glucocorticoid therapy (AGT) is recommended for HIV-positive individuals with hypoxia and Pneumocystis jirovecii pneumonia (PJP). Among solid organ transplant recipients, use of AGT is controversial but is generally recommended. Now, investigators report results of an international cohort study of 172 solid organ transplant recipients who received treatment for PJP from 2015 through 2020.

Most patients (81.6%) were recipients of abdominal organs, and none developed PJP while on prophylaxis. Overall, 43.4% required ICU care and 31.8% needed mechanical ventilation; 28.4% were diagnosed with CMV infection during the 3 months preceding their PJP diagnosis. Mortality at 90 days was 20.8%, and likelihood of graft loss was 30.8%. In all,…