Pneumocystis Pneumonia: Epidemiology and Options for Prophylaxis in Non-HIV Immunocompromised Pediatric Patients

The pediatric population of non-HIV immunocompromised patients at risk for Pneumocystis pneumonia (PCP) continues to increase. While prophylactic therapy can be highly effective in preventing this opportunistic pathogen, identifying the at-risk populations appropriate for use of prophylaxis and navigating the risks and benefits of each therapeutic option can be challenging. In this article, the available epidemiology for baseline rates of PCP is presented for a variety of non-HIV immunocompromised pediatric populations. Additionally, the comparative effectiveness and side effect profiles for trimethoprim/sulfamethoxazole, dapsone, atovaquone, and pentamidine are discussed. Institutions are encouraged to review the data and to establish and implement a local practice guideline for PCP prophylaxis that can be monitored for effectiveness over time. An example of a standardized practice guideline is suggested.