Question

When are steroids indicated in conjunction with TMP-SMX for PCP in HIV pts?

a) When there is a history of allergies
b) When the patient has a fever
c) When the patient is pregnant
d) When there is severe hypoxia

Answer 1

Steroids are indicated in conjunction with TMP-SMX for treating PCP in HIV patients when there is severe hypoxia, to reduce inflammation in the lungs and improve respiratory function.

Step-by-step explanation:

The question addresses the use of steroids in conjunction with TMP-SMX (trimethoprim-sulfamethoxazole) for the treatment of Pneumocystis pneumonia (PCP) in patients with HIV. Steroids are indicated when patients have severe hypoxemia or severe hypoxia, which is a significant reduction in blood oxygen levels. This is supported by evidence showing improved outcomes when corticosteroids are added to the treatment regimen for patients with PCP who have a partial pressure of arterial oxygen (PaO2) less than 70 mmHg or a respiratory rate over 30 breaths per minute or those who have diffuse bilateral infiltrates on chest X-ray. Steroids function to reduce inflammation in the lungs and improve respiratory function.