Intravenous pentamidine for Pneumocystis jirovecii pneumonia prophylaxis in immunocompromised patients without human immunodeficiency virus: a systematic review and meta-analysis

Review question / Objective: Breakthrough PJP rate and adverse reactions in HIV-uninfected immunocompromised patients who received intravenous pentamidine. Rationale: Trimethoprim-sulfamethoxazole (TMP-SMX) is a first-line Pneumocystis jirovecii pneumonia (PJP) prophylaxis agent, but intravenous pentamidine (IVP) every 4 weeks (Q4W) is commonly used in human immunodeficiency virus (HIV)-uninfected immunocompromised hosts because IVP is not associated with cytopenia and delayed engraftment. Breakthrough PJP rate on TMP-SMX prophylaxis, incidence of adverse reactions, and adverse events requiring discontinuation of TMP-SMX have been described in the literature. However, breakthrough PJP rate and adverse reactions are not well characterized in IVP.