Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Rheumatologists Practice for Prescribing Pneumocystis Prophylaxis
Cettomai, Deanna, Gelber, Allan C., Christopher-Stine, Lisa
Consensus guidelines for Pneumocystis pneumonia (PCP) prophylaxis in HIV-negative patients with rheumatologic disorders are lacking. We assessed rheumatologists' practice patterns for prescribing PCP prophylaxis.
Invitations to participate in an online international survey were emailed to 3150 American College of Rheumatology members.
Surveys were retuned by 727 (23.14%) individuals, of whom 505 (69.5%) reported prescribing prophylaxis. In univariate analyses, factors associated with significantly higher odds of prescribing PCP prophylaxis included female gender, US-based and academic practice of <10 years duration, having previously treated a patient with PCP pneumonia, and a practice with a higher proportion of patients on chronic glucocorticoids or other immunosuppressant medications. In multivariate analysis, rheumatologists early in their careers and those with a US-based practice, or a higher proportion of patients treated with chronic glucocorticoid therapy were most likely to prescribe PCP prophylaxis. Among the prescribers, the most important determinant factors for prescribing prophylaxis were treatment regimen (68.6%), rheumatologic diagnosis (9.3%), and medication dosage (8.3%).
Nearly one-third (30%) of rheumatologists surveyed reported that they never prescribed PCP prophylaxis. While the patients for whom physicians would prescribe prophylaxis varied widely, physician demographic characteristics were strongly predictive of prophylaxis use. Consensus guidelines would be helpful to guide clinical decision-making regarding PCP prophylaxis in HIV-negative patients with rheumatologic diagnoses.
To cite this abstract, please use the following information:
Cettomai, Deanna, Gelber, Allan C., Christopher-Stine, Lisa; Rheumatologists Practice for Prescribing Pneumocystis Prophylaxis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :327