{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:38:55Z","timestamp":1779248335921,"version":"3.51.4"},"reference-count":70,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pneumocystis pneumonia (PCP) is an opportunistic fungal infection. Several guidelines have been published to support its clinical management. However, the complexity and breadth of these guidelines pose challenges for consistent implementation in routine clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To develop a scoring tool and quality indicator that facilitates clinical decision making and quantifies adherence to best-practice guidelines for PCP in patients with and without HIV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Key recommendations for the diagnosis, treatment and follow-up of PCP were extracted from current guidelines of the European Council on Infections in Leukaemia (ECIL), the American Society of Transplantation Infectious Diseases Community of Practice (AST-IDCOP), and the IDSA guidelines. Each recommendation was assigned a point value ranging from \u22121 to 3, weighted according to the strength of recommendation and level of evidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The proposed 2025 European Confederation of Medical Mycology (ECMM) QUALity (EQUAL) Pneumocystis Score consists of 24 items for patients with HIV and 22 for patients without HIV. For diagnosis, bronchoalveolar lavage and immunofluorescence assays received the highest scores due to their superior sensitivity and specificity for sampling and analysis. Trimethoprim\/sulfamethoxazole is the treatment of choice and was awarded with the highest score. The addition of corticosteroids for patients with HIV and respiratory failure completes the treatment category. The score is completed with the patient follow-up. For HIV patients a maximum score of 31 and for non-HIV patients a maximum score of 27 is achievable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The 2025 EQUAL Pneumocystis Score offers a concise, evidence-based tool for the optimal management of PCP. This can be useful in daily practice for a quick overview and may be used to measure guideline adherence in research settings. It has not yet been assessed whether higher EQUAL Pneumocystis Scores are associated with improved patient outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf165","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T09:12:06Z","timestamp":1759137126000},"source":"Crossref","is-referenced-by-count":1,"title":["The 2025 EQUAL <i>Pneumocystis<\/i> Score\u2014an ECMM tool to measure QUALity in <i>Pneumocystis<\/i> pneumonia management"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4494-5159","authenticated-orcid":false,"given":"Luise","family":"Haensel","sequence":"first","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2457-6437","authenticated-orcid":false,"given":"Rosanne","family":"Sprute","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne , Cologne, NRW ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8498-231X","authenticated-orcid":false,"given":"Jan","family":"Grothe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-596X","authenticated-orcid":false,"given":"Florence","family":"Robert-Gangneux","sequence":"additional","affiliation":[{"name":"Mycology Department, Excellence Center for Medical Mycology (ECMM) and French National Center for Chronic Aspergillosis, Rennes University Hospital , Rennes ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-5607","authenticated-orcid":false,"given":"Jean-Pierre","family":"Gangneux","sequence":"additional","affiliation":[{"name":"Mycology Department, Excellence Center for Medical Mycology (ECMM) and French National Center for Chronic Aspergillosis, Rennes University Hospital , Rennes ,","place":["France"]},{"name":"CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Sant\u00e9, Environnement et Travail), UMR_S 1085, Univ Rennes , Rennes ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F","family":"Meis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne , Herderstrasse 52, Cologne, NRW 50931 ,","place":["Germany"]},{"name":"Department of Medical Microbiology and Infectious Diseases, Centre of Expertise in Mycology Radboudumc\/Canisius Wilhelmina Hospital , Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A","family":"Cornely","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne , 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