POS0949 clinical factors associated with pneumocystis pneumonia despite its primary prophylaxis: a case-control study
Abstract
Previous studies have suggested that primary prophylaxis against pneumocystis pneumonia (PCP) using trimethoprim-sulfamethoxazole (TMP-SMX) is beneficial in patients with rheumatologic diseases receiving immunosuppressive drugs[1]. However, there is little evidence for an optimal prophylaxis duration or a time point of prophylaxis withdrawal.This study aims to investigate the risk factors that are associated with PCP occurrence despite its primary prophylaxis, and, ultimately, to provide evidence regarding the ideal schedule for primary PCP prophylaxis.This case-control study included treatment episodes of patients with rheumatic diseases who received prophylactic TMP-SMX with immunosuppressive treatment between 2010 and 2022 in a tertiary referral center in South Korea. The index date was defined as the date of starting the prophylactic dose of TMP-SMX. We captured PCP cases that occurred within 1 year from the index date based on the review of the medical record by two independent expert investigators. The effect of clinical factors, such as demographics, underlying disease, immunosuppressive treatment, and pattern of prophylaxis on the PCP occurrence was examined using binary logistic regression.A total of 1,379 treatment episodes were analyzed, and eleven cases of PCP occurred during the observation—a one-year PCP incidence of 0.80 (95% CI=0.40-1.43) per 100 person-years. In 10 cases (90.9%), PCP occurred after discontinuation of TMP-SMX prophylaxis, with a mean (SD)…
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