PCP with steroids

Frequently invoked, rarely proven the development of PCP with steroid therapy is rare but important to consider.

TMP/SMX prophylaxis for PCP in patients on high dose steroids (Table below) from this meta-analysis. In general, though there is no consensus, PCP prophylaxis should be considered in patients on greater than 30mg of prednisone for greater than three months or those who are on moderate-high dose steroids with another immunosuppressive agent (i.e. patients with Wegner's)

However, the story may be different in lymphoma treatment, particularly with rituximab and high dose CHOP therapy but overall is also low in hematologic (exclude ALL) and solid organ malignancy.