Treatment for high-severity PJP in patients with hypersensitivity to trimethoprim+sulfamethoxazole

Trimethoprim+sulfamethoxazole is the optimal treatment for PJP; seek expert advice if alternative treatments are being considered.

Assess patients with high-severity PJP who report hypersensitivity to trimethoprim+sulfamethoxazole:

for adults, see Clinical history for initial assessment of adults reporting trimethoprim+sulfamethoxazole hypersensitivity
for children, seek expert advice.

Desensitisation is an option for clinically stable patients who report hypersensitivity to trimethoprim+sulfamethoxazole – seek expert advice if desensitisation is being considered. Do not desensitise patients:

with severe delayed¹ hypersensitivity
in whom adherence to therapy is unlikely – if 1 day of therapy is missed, the patient’s hypersensitivity will return and desensitisation must be performed again.

If desensitisation is not an option, see the alternative treatment options for high-severity PJP in adults or children.

Note: Assess patients reporting hypersensitivity to trimethoprim+sulfamethoxazole.

¹ Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return