Pcp prophylaxis steroid use

Thyroid storm is a life-threatening condition of the hyperthyroid state. 26 It most commonly occurs in patients with Graves' disease but may also occur in those with multinodular goiter or toxic adenoma. 27 It is treated by correcting the hyperthyroidism and treating the precipitating events. 26 Correction of the hyperthyroid state involves using drugs such as propylthiouracil or methimazole (Tapazole), beta blockers or corticosteroids, which decrease the peripheral effects of thyroid hormone and the conversion of thyroxine (T 4 ) to the more potent triiodothyronine (T 3 ). 22 , 26 Dexamethasone can be used for that purpose, at a dosage of 2 mg intravenously every six hours, and can eventually can be switched to an oral dosage of 2 mg every six hours. 28

A one-month supply of 600 mg tablets costs approximately $1,010 in July 2016. [19] In 2007, Merck provided efavirenz in certain developing countries and countries largely affected by HIV for about $ per day. [20] Some emerging countries have opted to purchase Indian generics. [21] In Thailand, one month supply of efavirenz + truvada, as of June 2012, costs THB 2900 ($90), and there is a social program for patients who cannot afford the medication. In South Africa, a license has been granted to generics giant Aspen Pharmacare to manufacture, and distribute to Sub-Saharan Africa , a cost-effective antiretroviral drug. [22]

2. Fosfomycin (PO)
Bactericidal agent that is excreted into the urine and inhibits cell wall synthesis by interfering with peptidoglycan synthesis.
Spectrum: Broad spectrum vs Gram positive including MRSA, VRE; Gram negative including Pseudomonas and some ESBL’s . 
Used for: Uncomplicated urinary tract infections in women, especially in those with history of resistant bugs.  Given as a one-time mega-dose of 3 g (excreted into urine and achieves high levels there for several days.   Sometimes used for complicated UTI’s in males with resistant pathogens (3 g PO q3 days x several doses), although this is an off-label use.

So CD4 counts appear to be a useful tool in assessing risk, but other factors also contribute such as lung architecture. In a retrospective study of 74 patients with interstitial lung disease on corticosteroids, 7 patients developed PCP. The mean dose at time of diagnosis was prednisone 37mg with mean duration of 10 weeks. CD4 counts ranged from 59 to 836, with a mean of 370 [24]. The authors argued that due to their underlying lung disease, the patients were at higher risk for PCP and became infected at higher CD4 counts than patients with other underlying diseases.

Pcp prophylaxis steroid use

pcp prophylaxis steroid use

So CD4 counts appear to be a useful tool in assessing risk, but other factors also contribute such as lung architecture. In a retrospective study of 74 patients with interstitial lung disease on corticosteroids, 7 patients developed PCP. The mean dose at time of diagnosis was prednisone 37mg with mean duration of 10 weeks. CD4 counts ranged from 59 to 836, with a mean of 370 [24]. The authors argued that due to their underlying lung disease, the patients were at higher risk for PCP and became infected at higher CD4 counts than patients with other underlying diseases.

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