Proposed PJP* prophylaxis with glucocorticoid use
| Underlying disease | Prophylaxis at glucocorticoid dose (Y/N)† | Discontinuation of prophylaxis at glucocorticoid dose (Y/N) | |
| 15–30 mg | >30 mg | <15 mg | |
| Granulomatosis with polyangiitis | Y | Y | Y‡ |
| Microscopic polyangiitis | Y | Y | Y‡ |
| Systemic sclerosis | Y§ | Y | Y |
| Dermatomyositis/polymyositis | Y§ | Y | Y |
| Systemic lupus erythematosus | N | Y | Y |
| Rheumatoid arthritis | N | Y§ | Y |
*Based on limited data and expert opinion, the authors advocate additional studies to further refine recommendations in this area.
†Requires prolonged glucocorticoids (≥4 weeks).
‡Conditional on <2 additional risk factors at time of discontinuation: baseline lymphopaenia, low CD4 count, cyclophosphamide use, anti-TNF or rituximab use, initial glucocorticoid dose of >60 mg.
§Conditional on at least one additional risk factor: baseline lymphopaenia, low CD4 count, cyclophosphamide use, anti-TNF or rituximab use, initial glucocorticoid dose of >60 mg.