Diagnosis and treatment protocols for Pneumocystis Pneumonia in Uganda
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Clinical Features
Fever, dry cough, shortness of breath (significant hypoxemia) in a severely immunosuppressed patient. Chest x-ray shows characteristic bilateral interstitial infiltrates.
Treatment
First Line
Give oxygen if SpO2 <94%. Cotrimoxazole 120 mg/kg/daily in 2-4 divided doses for 21 days (e.g., if <60kg: 3 tablets of 480mg; if >60kg: 4 tablets). PLUS Prednisolone 2 mg/kg daily in 3 divided doses for 5 days, then reduce dose to complete 21 days.
Alternative
Pentamidine 4 mg/kg by IV infusion daily for 21 days (reduce dose in renal impairment). OR Clindamycin 600 mg every 8 hours + Dapsone 100 mg daily for 21 days.
Prophylaxis
Give to all patients with history of PCP and severely immunocompromised. Cotrimoxazole 960 mg daily OR Dapsone 100 mg daily. Continue until immunity recovers.
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