{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T10:46:06Z","timestamp":1781174766919,"version":"3.54.1"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fonds de Recherche Qu\u00e9bec - Sant\u00e9"},{"DOI":"10.13039\/100013392","name":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pneumocystis jirovecii pneumonia (PCP) is a common opportunistic infection causing more than 400000 cases annually worldwide. Although antiretroviral therapy has reduced the burden of PCP in persons with human immunodeficiency virus (HIV), an increasing proportion of cases occur in other immunocompromised populations. In this review, we synthesize the available randomized controlled trial (RCT) evidence base for PCP treatment. We identified 14 RCTs that were conducted 25\u201335 years ago, principally in 40-year-old men with HIV. Trimethoprim-sulfamethoxazole, at a dose of 15\u201320 mg\/kg per day, is the treatment of choice based on historical practice rather than on quality comparative, dose-finding studies. Treatment duration is similarly based on historical practice and is not evidence based. Corticosteroids have a demonstrated role in hypoxemic patients with HIV but have yet to be studied in RCTs as an adjunctive therapy in non-HIV populations. The echinocandins are potential synergistic treatments in need of further investigation.<\/jats:p>","DOI":"10.1093\/ofid\/ofab545","type":"journal-article","created":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T16:38:07Z","timestamp":1635698287000},"source":"Crossref","is-referenced-by-count":25,"title":["On the Treatment of <i>Pneumocystis jirovecii<\/i> Pneumonia: Current Practice Based on Outdated Evidence"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0783-0624","authenticated-orcid":false,"given":"Emily G","family":"McDonald","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montr\u00e9al, Canada"},{"name":"Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-0396","authenticated-orcid":false,"given":"Guillaume","family":"Butler-Laporte","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Del Corpo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy M","family":"Hsu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-3161","authenticated-orcid":false,"given":"Alexander","family":"Lawandi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Senecal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra N","family":"Sohani","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Laboratory Medicine, McGill University Health Centre, Montr\u00e9al, Canada"},{"name":"Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd C","family":"Lee","sequence":"additional","affiliation":[{"name":"Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montr\u00e9al, Canada"},{"name":"Department of Epidemiology, Occupational Health, and Biostatistics, McGill University, Montr\u00e9al, Canada"},{"name":"Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"2021122217120464600_CIT0001","doi-asserted-by":"crossref","first-page":"3577","DOI":"10.1007\/s00436-015-4678-6","article-title":"Pneumocystis jirovecii\u2013from a commensal to pathogen: clinical and diagnostic 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