Chapter 21: Haematological procedures
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Related theory
Pneumocystis jirovecii pneumonia is a fungal infection of the lungs. The disease has also been referred to as Pneumocystis carinii or PCP pneumonia (Anevlavis et al. [3]). The fungus is common within the environment and rarely causes illness in healthy people. However, in patients with a weakened immune system and those undergoing stem cell transplantation it can lead to a lung infection that can be fatal (Anevlavis et al. [3]).
Prophylaxis against Pneumocystis jirovecii pneumonia is indicated in all haematopoietic stem cell transplant and severely immunocompromised patients (Joint Formulary Committee [62]). Co‐trimoxazole by mouth is the first‐line drug recommended for prophylaxis against pneumocystis pneumonia (Joint Formulary Committee [62]). Where this is contraindicated, or a patient is unable to tolerate co‐trimoxazole, nebulized pentamidine isetionate is indicated (Brown and Cutler [16], Joint Formulary Committee [62]). Pentamidine isetionate is given by inhalation of a nebulized solution at 300 mg every 4 weeks (Joint Formulary Committee [62]).
Pentamidine isetionate is classed as a substance hazardous to health. In accordance with COSHH Regulations ([24]), exposure to pentamidine isetionate must be reduced to ‘as low a level as is reasonably practicable’, where its use cannot be eliminated.
