Yukawa et al reported a score for identifying a patient with rheumatoid arthritis who is at increased risk for pneumocystis pneumonia. A patient at high risk may be a candidate for prophylactic antibiotic therapy. The authors are from Tsuchiya General Hospital in Hiroshima.
Patient selection: rheumatoid arthritis
Parameters:
(1) methotrexate dose in mg per week
(2) age in years
(3) number of immunosuppressant medications
(4) prednisolone in mg per day
Parameter
Finding
Points
methotrexate
< 6 mg/week
0
>= 6 mg/week
1
age in years
< 65 years of age
0
>= 65 years of age
1
number of immunosuppressant drugs
0 or 1
0
>= 2
1
prednisolone dose
< 5 mg/day
0
>= 5 mg/day
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• Prophylaxis is recommended for a score > = 5.
Total Score
Risk Group
Incidence PJP
0 to 2
low
0.04%
3 or 4
intermediate
2.3%
5 or 6
high
5.8%
To read more or access our algorithms and calculators, please log in or register.
