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HIV & AIDS Health Center

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AIDS, HIV, and Pneumocystis Pneumonia (PCP)

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Treating Pneumocystis Pneumonia

If you develop PCP, you are likely to take Bactrim, Septra, or Cotrim. These drugs are combinations of two antibiotics (trimethoprim and sulfamethoxazole, or TMP/SMX). Depending upon how sick you are, you take TMP/SMX as a pill or intravenously through your vein (by IV) in a hospital. It is frequently combined with a course of oral steroids.

Some people have allergies to SMX, which is a sulfa drug. If you do, your doctor may have you try another medication. Or you may cut back on SMX and gradually increase the dose (called desensitization). Do this only under the guidance of your doctor.

Other drugs doctors use to fight the infection include:

  • Dapsone (sometimes combined with TMP or pyrimethamine), taken by pill
  • NubuPent, Pentam, or Pentacarinat (pentamidine), inhaled as an aerosol through a machine called a nebulizer. You may need to do this in a doctor's office or a clinic. It can also be injected into the vein for serious infection.
  • Mepron (atovaquone), taken in a liquid (called oral suspension) with food. This may be used when TMP/SMX or pentamidine can't be taken.

If you have moderate to severe PCP and low oxygen levels, you may also receive corticosteroid drug.

Preventing Pneumocystis Pneumonia

There is no vaccine available to prevent this type of pneumonia. Because it raises CD4 counts, HAART is the best way to prevent PCP. If you are a smoker, you can reduce your risk for PCP by quitting.

Another key to prevention is starting PCP drugs before CD4 cell counts drop too low or you become too sick. You can take the same medication as that used to treat PCP, including TMP/SMX, but at different doses and frequency. Your doctor may recommend this if any of these things occur:

  • You have had PCP in the past.
  • Your CD4 count falls below 200.
  • Your CD4 count falls below 300 and you have another opportunistic infection such as thrush, a fungal mouth infection. This infection may raise your risk for PCP.
  • You are taking drugs that suppress the immune system.

If you have had PCP, you may need to continue taking medication to avoid recurrence. However, you may be able to stop taking PCP drugs if your CD4 count goes over 200 and stays there for at least three months.

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on July 08, 2015
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