ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

J Antimicrob Chemother. 2016 Sep;71(9):2397-404. doi: 10.1093/jac/dkw157. Epub 2016 May 12.


The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk. Recent data indicate that children may benefit equally from a once-weekly regimen ( B-II: ). All other drugs, including pentamidine, atovaquone and dapsone, are considered second-line alternatives when trimethoprim/sulfamethoxazole is poorly tolerated or contraindicated. The main indications of PCP prophylaxis are ALL, allogeneic HSCT, treatment with alemtuzumab, fludarabine/cyclophosphamide/rituximab combinations, >4 weeks of treatment with corticosteroids and well-defined primary immune deficiencies in children. Additional indications are proposed depending on the treatment regimen.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Chemoprevention / methods*
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / therapy
  • Humans
  • Immunocompromised Host*
  • Pneumonia, Pneumocystis / prevention & control*
  • Stem Cell Transplantation / adverse effects*
  • Transplant Recipients*
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage


  • Antifungal Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination