PJP treatment guidelines IDSA

Abstract. Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia. Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations IDSA Clinical Practice Guidelines are developed by a panel of experts who perform a systematic review of the available evidence and use the GRADE process to develop evidence-based recommendations to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances.. IDSA Clinical Guidance documents are developed based on a comprehensive. This report was followed by a guideline on prevention of . Mycobacterium avium. complex (MAC) disease in 1993 (33). In 1995, these guidelines were expanded to include the prevention of all HIV-related OIs and the Infectious Diseases Society of America (IDSA) joined as a cosponsor (34). These prevention guidelines were revised in 1997, 1999, and.

aggressive treatment regimens is an increased risk of opportun-istic infections (OIs) [, 3]. Pneumocystis pneumonia (PCP) is 2 a traditional OI that occurs at varying frequencies in non-HIV-infected immunocompromised patients [, 54] and is particularly associated with significant mortality in patients with underlying CTDs [] Epidemiology. Pneumocystis pneumonia (PCP) is caused by Pneumocystis jirovecii, a ubiquitous fungus.The taxonomy of the organism has been changed; Pneumocystis carinii now refers only to the Pneumocystis that infects rats, and P. jirovecii refers to the distinct species that infects humans. However, the abbreviation PCP is still used to designate Pneumocystis pneumonia

Diagnosis and Treatment of Adults with - IDSA Hom

Overview Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV document is published in an electronic format that can be easily updated as relevant changes in prevention and treatment recommendations occur This is not specific for PJP, but rather can be seen with a variety of fungal infections (e.g., aspergillus, histoplasma, cryptococcus, or candida). Even colonization with candida may generate a positive assay (Morjaria et al. 2019). Causes of a false-positive assay include: Treatment with intravenous immunoglobulin (IVIG) treatment period. PJP risk in patients with haematological malignancy Specific patient groups with underlying haematological malignancy have been identified to be at high risk of PJP.31 These findings have been used to inform guidelines regarding institution of PJP prophylaxis. However, there have been important shifts in the treatment o

Objective: To review published abstracts, case reports, and journal articles and evaluate data examining the use of systemic corticosteroids as adjuvant treatment for Pneumocystis carinii pneumonia (PCP) in patients with AIDS. Data sources: Computerized online databases, peer-reviewed journals from January 1986 through September 1991, and personal communication with a National Institutes of. These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of Pneumocystis jiroveci fungal infection transplant recipients. Pneumonia (PJP) may develop via airborne transmission or reactivation of prior infection

Practice Guidelines - IDSA Hom

IDSA/ATS Guidelines for CAP in Adults • CID 2007:44 (Suppl 2) • S27 SUPPLEMENT ARTICLE Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults Lionel A. Mandell,1,a Richard G. Wunderink,2,a Antonio Anzueto,3,4 John G. Bartlett,7 G. Douglas Campbell, ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients J Antimicrob Chemother. 2016 Sep;71(9):2405-13. doi: 10.1093/jac/dkw158. Epub 2016 May 12. Authors Georg Maschmeyer 1. CDC. 1995 revised guidelines for prophylaxis against Pneumocystis carinii pneumonia for children infected with or perinatally exposed to human immunodeficiency virus. MMWR 1995;44(No. RR-4):1-11. CDC. 1994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age Purpose To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on. Pneumocystis pneumonia (PCP) generally occurs in immunocompromised hosts and can be a life-threatening infection leading to respiratory decompensation. The causative organism, P jiroveci, is thought to colonize the lungs via airborne transmission in childhood, and reactivate in susceptible hosts at the time of immunosuppression, similar to latent tuberculosis infection

The update of the 2013 ASCO Guidelines for Antimicrobial Prophylaxis for Immunosuppression in Adults Treated for Malignancy is being carried out in partnership with the Infectious Diseases Society of America (IDSA). 6,7 ASCO methodology relies on analysis of strength and quality of evidence; IDSA employs the grading of recommendations. Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii. Most people who get PCP have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines (such as corticosteroids) that lower the body's ability to fight germs and sickness. In the United States, people with HIV/AIDS are. primaquine but do not delay treatment. If O 2 saturations <92% or PaO 2 ≤9.3kpa on room air start steroids at the same time as treatment (or within 72 hours). Prednisolone oral 40mg bd for 5 days, 40mg od for 5 days then 20mg daily for 11 days then stop. If IV required use methylprednisolone at 75% of oral prednisolone dose

Pneumocystis Pneumonia NI

Purpose: To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods: ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016 To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016 Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV external link opens in a new window Centers for Disease Control and Prevention; National Institutes of Health; HIV Medicine Association of the Infectious Diseases Society of America. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV

Managing PJP treatment failure. Clinical failure is defined as lack of improvement or worsening of respiratory function documented by reduced arterial oxygen saturation after at least 4-8 days of Pneumocystis treatment. Early and reversible deterioration in the first 3-5 days is typical, and clinicians should wait at least 4-8 days before. Pneumocystis pneumonia remains the most prevalent opportunistic infection in patients infected with the human immunodeficiency virus. Molecular techniques have provided new insights into the comple.. Please let us know if there are guidelines that should be added - susann.blossfeld@uk-koeln.de Provides Guidance on Published in Organization Reference Febrile Neutropenia Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients 2017 Infectious Diseases Working Party (AGIHO) o Prophylaxis. Antimicrobial prophylaxis is highly successful in preventing PJP in patients with immunosuppression from a diverse range of causes, including solid-organ transplantation and malignancy. r Guidelines have been published for the use of PJP prophylaxis in patients with cancer, including blood and marrow transplant (BMT) recipients. r r In a meta-analysis of randomized trials of PJP.

Guidelines for the Prevention and Treatment of

  1. ANMC Clostridium difficile Infection (CDI) Prophylaxis Guideline Risk Factors If ongoing therapy with C. difficile predisposing antimicrobial regimen, upon completion of 10-14 days of QID dosing for treatment, may continue enteral vancomycin BID until completion of therapy
  2. Pneumocystis Pneumonia Treatment of Other Fungi Glossary of Terms America (IDSA) have recently adopted the GRADE approach to grading the quality of evidence and strength of recommenda-tions for clinical guidelines, the current project was initiated an
  3. Treatment 09/15/2020 PIDS and IDSA Issue Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children Pneumocystis carnii Pneumonia: A Clinical Review.
  4. Pneumocystis jirovecii infections in (non HIV-infected) adult and pediatric • Treatment of graft rejection or graft-versus-host disease (GvHD) the CBMTG, the IDSA, the SHEA, the AMMI, and the CDC Recommendation for adults: Gea-Banacloche 2009 A= should always be offered/B=should generally be offered/C=optional . Baden 2012 NCCN.

Pneumocystis jirovecii pneumonia (PJP) remains a common and highly morbid infection for immunocompromised patients. Trimethoprim-sulfamethoxazole (TMP-SMX) is the antimicrobial treatment of choice. However, treatment with TMP-SMX can lead to significant dose-dependent renal and hematologic adverse events Test. Patients with a clinical presentation suggestive of Pneumocystis pneumonia (PCP), but a normal or unchanged chest x-ray, should undergo either an HRCT scan of the chest or pulmonary function tests with measurement of diffusing capacity for carbon monoxide.. If the HRCT scan shows ground glass opacities, the patient should undergo sputum induction followed by bronchoalveolar lavage (if. Pneumocystis pneumonia ( PCP) prophylaxis is used in certain patients, such as allogeneic HCT recipients, selected autologous HCT recipients. ›. Fungal infections following lung transplantation. found between once-daily and thrice-weekly administration schedules for TMP-SMX. Although PCP prophylaxis is highly effective, some cases have.

Pneumocystis Jiroveci Pneumonia (PJP) - EMCrit Projec

Adjuvant corticosteroid therapy for Pneumocystis carinii

TREATMENT. Trimethoprim-sulfamethoxazole — We recommend trimethoprim-sulfamethoxazole (TMP-SMX) as the treatment of choice for PCP of any severity in HIV-uninfected patients ( table 1) [ 1 ]. The dose of TMP-SMX for patients with normal renal function is 15 to 20 mg/kg (dosing is based upon the TMP component and expressed as mg/kg per day of. Pneumocystis jiroveci pneumonia (PCP) is a common opportunistic infection in organ transplant recipients who do not receive effective prophylaxis. Trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred agent for prophylaxis. Atovaquone has been useful as an alternative agent for prophylaxis against PCP Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases: An Official ATS/IDSA Statement (2007) Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases - Online Supplement: An Official ATS/IDSA Statement (2007) IDSA/ATS Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults (2007

Pneumocystis jiroveci in solid organ transplantation

Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America Pneumocystis jirovecii is an opportunistic pathogen that was first widely recognized early in the HIV epidemic [1, 2].In addition to HIV infection, Pneumocystis causes pneumonia in patients with solid organ and stem cell transplants, those receiving corticosteroids and other immune-modulating agents, and individuals with other immunocompromising conditions [] Expert Commentary: Pneumocystis jerovecii pneumonia (PJP) is a life threatening and severe infection that traditionally affected individuals with AIDS. As described in the blog piece the epidemiology of affected patient populations has changed over the past 20 years with effective HIV therapy Pneumocystis jirovecii pneumonia (PJP) is an opportunistic fungal infection primarily affecting immunocompromised patients. Adults with HIV (particularly CD4 ≤200 cells/µL), solid organ and allogeneic hematopoietic stem cell transplant recipients, as well as patients on certain chemotherapies, immunosuppressant drugs, and systemic corticosteroids are at a highest risk

ECIL guidelines for treatment of Pneumocystis jirovecii

USPHS/IDSA Guidelines for the Prevention of Opportunistic

Pneumocystis carinii Pneumonia. 2nd ed. Marcel Dekker; 1994. p. 25-43. Cushion MT, Ruffolo JJ, Walzer PD. Analysis of the developmental stages of Pneumocystis carinii in vitro. Lab Invest 1988;58:324-331. This is a generalized life cycle proposed by John J. Ruffolo, Ph.D. (Cushion, MT, 1988) for the various species of Pneumocystis. These fungi. IDSA Guidelines. Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Browse the latest guidelines today. Learn more Guideline-concordant therapy and reduced mortality and length of stay in adults with community-acquired pneumonia: playing by the rules. Arch Intern Med. 2009 Sep 14. 169 (16):1525-31. [Medline. Treatment Guidelines for CAP Recognizing that the majority of patients are treated by PCPs, hospitalists and emergency medicine specialists, committees of IDSA and ATS have formulated guidelines. PJP Treatment Infection 1 American Thoracic Society/Infectious Diseases Society of America Consensus guidelines on the management of community-acquired pneumonia in adults. IDSA/ESCMID Guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women

Antimicrobial Prophylaxis for Adult Patients With Cancer

  1. Guidelines for prophylaxis against Pneumocystis carinii pneumonia for persons infected with human immunodeficiency virus. MMWR Morb Mortal Wkly Rep . 1989;38(suppl 5):1-9
  2. The ATS/IDSA CAP guidelines endorse the Surviving Sepsis Campaign recommendations on using corticosteroids in patients with CAP who have refractory septic shock. Anti-influenza therapy Anti-influenza treatment (eg, oseltamivir) should be prescribed to all adults with CAP, regardless of hospitalization status, who test positive for influenza
  3. Answer. Antibiotics are primarily recommended for treatment of mild, moderate, or severe P jiroveci pneumonia (PJP). TMP-SMX has been shown to be as effective as intravenous pentamidine and more.
  4. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. HIVinfo 2020 Aug 18 PD
  5. Chest x-ray and assessment of oxygenation (usually by pulse oximetry) are done in immunocompromised patients with respiratory symptoms, signs, or fever. If an infiltrate or hypoxemia is present, diagnostic studies should be done. Chest x-ray may be normal in Pneumocystis jirovecii pneumonia, but hypoxia or an increased alveolar-arterial oxygen gradient is usually present
  6. Abstract: Published guidelines for community-acquired pneumonia (CAP) have informed management and treatment recommendations for 25 years. Since inception, CAP guidelines have been developed for nearly every region of world, in part owing to improved mortality, clinical outcomes, and costs associated with implementation of guideline based care
  7. Immunosuppression, Infection and Immunisation in Rheumatology. Date last published: 11 February 2019. As initiation of immune suppressive therapy is often (semi-) elective, it is essential to check the immune status of patients as early as possible so that routine and extra immunisations can be completed before immunosuppressive medication.

Corticosteroid Use and Pneumocystis Pneumonia Prophylaxis

Guidelines for Prophylaxis Against Pneumocystis carinii Pneumonia for Children Infected with Human Immunodeficiency Virus . The Working Group on PCP Prophylaxis in Children was convened by the National Pediatric HIV Resource Center at Children's Hospital of New Jersey, New Jersey Medical School Newark, New Jersey IMPLICATIONS FOR TREATMENT. When they come to the hospital with pneumonia, patients with AUD are often empirically treated with broad-spectrum antimicrobials of different classes to cover resistant gram-negative and gram-positive organisms. 2,16,18,26,45 The IDSA guidelines support this approach. In addition, the more severe presentation of.

13. Freifeld AG, Bow EJ, Sepkowitz KA, et al: Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 52:e56-93, 2011 14 duration of antibiotic treatment for this patient according to the 2012 IDSA guidelines for diabetic foot infection. A. IV antibiotics x 7 more days B. IV antibiotics x 10 more days C. PO antibiotics x 5 more days D. PO antibiotics x 14 more days EMPIRIC COVERAGE- # 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112-146. Cryptococcosis Perfect JR et al. Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America This guideline statement evaluates criteria for diagnosis, defines the optimal methods for diagnostic testing, and summarizes treatment options for small intestinal bacterial overgrowth. This guideline provides an evidence-based evaluation of the literature through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE. 12. Tomblyn M, Chiller T, Gress R, et al. Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplantation Recipients: A Global Perspective. Biol Blood Marrow Transplant.. 2009; 15: 1143-1238. 13. UCDH Therapeutic Guidelines for the Management of Common Fungal Infections in Adult Patients

Video: Guidelines for the Prevention and Treatment of - HIV

Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematological malignancies and solid tumors Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) S. Neumann & S. W. Krause & G. Maschmeyer & X. Schiel & M. von Lilienfeld-Toa INTRODUCTION. Pneumocystis pneumonia (PCP) is a potentially life-threatening infection that occurs in immunocompromised individuals.The nomenclature for the species of Pneumocystis that infects humans has been changed from Pneumocystis carinii to Pneumocystis jirovecii; this was done to distinguish it from the species that infects rats.. Patients with HIV and a low CD4 count are at the highest.

Fishman JA. Prevention of infection due to Pneumocystis carinii. Antimicrob Agents Chemother 1998; 42:995. Fishman JA. Pneumocystis jiroveci. Semin Respir Crit Care Med 2020; 41:141. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58:e44 Treatment. Treat at least 21 days, then secondary prophylaxis until CD4 count > 200 cells/μL and HIV-VL undetectable over 3 months; Diagnosis:; Definitive diagnosis: Cough and dyspnoea on exertion AND microorganism identification by cytology / histopathology of induced sputum (sensitivity up to 80%), bronchoalveolar lavage (sensitivity > 95%) or bronchoscopic tissue biopsy (sensitivity > 95% Pneumocystis jirovecii is most likely transmitted via the airborne route and disease occurs by acquisition of new infection or by reactivation of latent infection. The risk of developing Pneumocystis pneumonia increases markedly with advanced immunosuppression and approximately 90% of individuals with PCP have a CD4 count less than 200 cells.

Pneumocystis carnii Pneumonia: A Clinical Review

  1. and treatment data (see Table 1). Treatment strategies were then compared to the most recent IDSA-endorsed practice guidelines.1 For HIV+ patients, the class A1 recommendation for the treatment of cryptococcal meningitis involves all of the following: 1. Induction- 2 weeks of amphotericin B(0.7-1 mg
  2. The guideline also required that after 48 hours antibiotic treatment be modified on the basis of the available culture results. De-escalation was achieved in 61.5% of patients. An additional feature of the protocol was an attempt to limit therapy to a 7-day course of appropriate antibiotic(s) for patients with VAP
  3. There were numerous knowledge gaps in 2000 when the ASBMT/IDSA/CDC guidelines were published and there remain many today. Continued study is necessitated by changing transplantation practices, emerging pathogens, alterations in drug susceptibilities, and new diagnostic testing
  4. In patients with Pneumocystis jirovecii pneumonia and hypoxia, prednisone therapy reduced the risk of death; 2 however, in outbreaks of other novel coronavirus infections (i.e., Middle East respiratory syndrome [MERS] and severe acute respiratory syndrome [SARS]), corticosteroid therapy was associated with delayed virus clearance. 3,4 In severe.
  5. Management of infections due to nontuberculous mycobacteria in solid organ transplant recipients—Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Sarah A. Longworth, Jennifer S. Daly, on behalf of the AST Infectious Diseases Community of Practice. , e13588
  6. Infectious Diseases Society of America. Clin Infect Dis. 1994 Mar; 18 (3):421-421. Kaplan JE, Hanson DL, Navin TR, Jones JL. Risk factors for primary Pneumocystis carinii pneumonia in human immunodeficiency virus-infected adolescents and adults in the United States: reassessment of indications for chemoprophylaxis

Ventilator-associated pneumonia (VAP) is a type of HAP that develops more than 48 to 72 hours after endotracheal intubation. Clinical VAP was defined according to the ATS/IDSA guidelines as a radiographic finding suggestive of a pulmonary infection plus two of the three following signs: temperature >101F or <96F, WBC count >11 or < 4 , and visually mucopurulent tracheal secretions USPHS/IDSA Prevention of Opportunistic Infections Working Group. 2001 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, November 28, 2001 the Infectious Diseases Society of America (IDSA) are widely used in patients with community-acquired pneumonia (CAP) in Japan. To evaluate how correctly these conventional prognostic guidelines for CAP reflect the severity of non-HIV PCP, we retrospectively analyzed 21 patients with non-HIV PCP There were no differences in emergence of macrolide resistance during treatment. While the 2007 American Thoracic Society (ATS)/IDSA guidelines recommend TIW therapy for patients with NB-MAC, relatively few data support this recommendation, and heterogeneous populations were studied to produce those data. Although long-term patient follow-up.

› Pjp treatment guidelines idsa › surgical prophylactic antibiotics guidelines › Idsa opportunistic infection guidelines 2000 to January 2012 were searched and evaluated according to the 2001 evidence-based medicine criteria used by the Infectious Diseases Society of America. Although our primary aim was to assess the relative merits of each compound, alone or in combination, for the prevention of disseminated Mycobacterium avium complex, data on the occurrence of other opportunistic infections, such as cryptosporidiosis, toxoplasmosis, and bacterial infections, were prospectively collected and analysed. We present an analysis of the additional effectiveness of.

The IDSA guidelines for empiric treatment apply only to the patients who have no etiologic diagnosis. Recommendations would be much more specific once the etiologic agent is known. Community-acquired pneumonia (CAP) is one of the most common infectious diseases and is an important cause of mortality and morbidity worldwide. Typical bacterial pathogens that cause the condition include Streptococcus pneumoniae (penicillin-sensitive and -resistant strains), Haemophilus influenza (ampicillin-sensitive and -resistant strains.. Clinical Practice Guideline . Antibiotic Stewardship . These guidelines are provided to assist physicians and other clinicians in making decisions regarding the care of their patients. They are not a substitute for individual judgment brought to each clinical situation by the patient's primary care provider in collaboration with the patient

Severe disease. Co-trimoxazole in high dosage, given by mouth or by intravenous infusion, is the drug of choice for the treatment of severe pneumocystis pneumonia. Pentamidine isetionate given by intravenous infusion is an alternative for patients who cannot tolerate co-trimoxazole, or who have not responded to it. Pentamidine isetionate is a potentially toxic drug that can cause severe. Introduction. Pneumocystis jiroveci (P. jiroveci) is a common opportunistic fungus causing Pneumocystis jiroveci pneumonia (PJP) in HIV infected patients. It is also a major opportunistic infection in HIV-negative immunocompromised patients, such as malignancy, stem cell transplantation (SCT), solid organ transplantation, rheumatologic disease, and respiratory disease.1 Mycobacterium abscessus. Pneumocystis jirovecii, formerly named Pneumocystis carinii, is one of the most common opportunistic infections in human immunodeficiency virus (HIV)-infected patients [1, 2].Spontaneous pneumothorax has been recognized as a frequent complication in patients with P. jirovecii pneumonia (PCP) since it was first described in 1984 [], and pneumomediastinum is an uncommon complication associated. Background Non-HIV Pneumocystis pneumonia (PCP) can occur in immunosuppressed patients having malignancy or on immunosuppressive agents. To classify severity, the A-DROP scale proposed by the Japanese Respiratory Society (JRS), the CURB-65 score of the British Respiratory Society (BTS) and the Pneumonia Severity Index (PSI) of the Infectious Diseases Society of America (IDSA) are widely used. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 July 2021), Cerner Multum™ (updated 1 July 2021), ASHP (updated 30 June.