[Antibiotic prophylaxis when taking corticosteroids].

Abstract

Antibioprophylaxis in the setting of high-dose corticosteroid therapy is primarily indicated for the prevention of Pneumocystis jirovecii pneumonia (PJP), a potentially fatal infection in immunocompromised individuals. According to the American Thoracic Society (2010) and National Comprehensive Cancer Network (NCCN) guidelines (2024), prophylactic administration of co-trimoxazole is recommended only for patients who are immunocompromised and receiving corticosteroid therapy at doses ≥20 mg of prednisone equivalent per day for ≥28 days. Deviation from these guidelines may unnecessarily expose patients to serious and potentially life-threatening adverse effects of co-trimoxazole, such as agranulocytosis.