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Pneumocystosis from Exposure to Immunosuppressants

J Am Acad Dermatol; ePub 2019 Jan 9; Rekhtman, et al

Incidence of pneumocystosis among patients exposed to immunosuppressants is very low, according to a recent study. Therefore, prophylaxis for patients receiving combination immunosuppressant and corticosteroid therapy, the group at highest risk, may be warranted. Researchers conducted a retrospective cohort analysis identifying incident pneumocystosis cases among adults without HIV/AIDS or cancer exposed to immunosuppressant and/or corticosteroid therapy. They found:

  • 406 new cases were identified among patients prescribed an immunosuppressant, corticosteroid, or both.
  • Overall incidence of pneumocystosis was 0.012% (406/3,366,086).
  • Incidence was highest in those exposed to immunosuppressant and corticosteroid medications (0.199%), followed by groups exposed to immunosuppressant alone (0.012%), corticosteroid alone (0.008%), and neither medication (0.001%).
  • Greatest risk differences were noted between groups exposed to immunosuppressant and corticosteroid compared with neither (0.198%) and with immunosuppressant alone (0.188%).
  • Greatest relative risks were noted among those receiving immunosuppressant and corticosteroid compared with those exposed to neither or to immunosuppressant alone.
Citation:

Rekhtman S, Strunk A, Garg A. Incidence of pneumocystosis among patients exposed to immunosuppression. [Published online ahead of print January 9, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.12.052.

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