Cmv pneumonitis steroids

For patients with chronic disease (persistent disease activity 12 months after diagnosis), weekly oral methotrexate has been used to limit steroid use. Other second line drugs, such as IM gold, D-penicillamine, hydroxychloroquine and azathioprine, have been used as well. Cyclophosphamide, because of its toxicity, should be reserved for the most exceptional cases. Lastly, the role of anti-TNF therapy in the treatment of adult Still’s disease refractory to conventional therapy appears promising10 but further studies to evaluate the long-term safety and efficacy are needed.

2. Fosfomycin (PO)
Bactericidal agent that is excreted into the urine and inhibits cell wall synthesis by interfering with peptidoglycan synthesis.
Spectrum: Broad spectrum vs Gram positive including MRSA, VRE; Gram negative including Pseudomonas and some ESBL’s . 
Used for: Uncomplicated urinary tract infections in women, especially in those with history of resistant bugs.  Given as a one-time mega-dose of 3 g (excreted into urine and achieves high levels there for several days.   Sometimes used for complicated UTI’s in males with resistant pathogens (3 g PO q3 days x several doses), although this is an off-label use.

CMV antigenemia assays employ tagged monoclonal antibody that is specific to the CMV pp65 matrix protein in peripheral blood polymorphonuclear leukocytes ( 63 ). Results are reported as the number of positive cells per total number of cells counted. Antigenemia assays are operator-dependent and the technique lacks standardization. Peripheral blood polymorphonuclear leukocytes have short half-lives and thus antigenemia assay should be performed immediately and preferably within 6 hours. Because of the need for polymorphonuclear leukocytes, the utility of antigenemia assay in neutropenic patients is very limited.

10 mg/kg/dose PO 3 times per day (Max: 1,000 mg/day) may be beneficial for some patients with frequent recurrences. Reevaluate after 6 to 12 months of continuous therapy. No clinical studies of prophylactic therapy for herpes labialis have been performed in children. For HIV-infected patients, 20 mg/kg/dose PO twice daily (Max: 800 mg/dose) is recommended by clinical guidelines. After prolonged period (., 1 year) of prophylaxis, consider stopping prophylaxis and assess patient to determine if additional prophylaxis is required. Although level of immune reconstitution should be a consideration, specific CD4 thresholds have not been determined.

Cmv pneumonitis steroids

cmv pneumonitis steroids

10 mg/kg/dose PO 3 times per day (Max: 1,000 mg/day) may be beneficial for some patients with frequent recurrences. Reevaluate after 6 to 12 months of continuous therapy. No clinical studies of prophylactic therapy for herpes labialis have been performed in children. For HIV-infected patients, 20 mg/kg/dose PO twice daily (Max: 800 mg/dose) is recommended by clinical guidelines. After prolonged period (., 1 year) of prophylaxis, consider stopping prophylaxis and assess patient to determine if additional prophylaxis is required. Although level of immune reconstitution should be a consideration, specific CD4 thresholds have not been determined.

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