Which agent is used for both prophylaxis and treatment of Pneumocystis jirovecii pneumonia?

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Multiple Choice

Which agent is used for both prophylaxis and treatment of Pneumocystis jirovecii pneumonia?

Explanation:
Trimethoprim-sulfamethoxazole (Bactrim) is used for both prevention and treatment of Pneumocystis jirovecii pneumonia. It blocks sequential steps in folate synthesis, hindering DNA replication of Pneumocystis and making it highly effective. For prophylaxis in high-risk patients, a lower, ongoing dose keeps the organism from establishing infection. For treatment, a higher-dose regimen is given for about 14–21 days, with adjunctive corticosteroids if there is significant hypoxemia. Other drugs can be used as alternatives (for example, dapsone or atovaquone for prophylaxis when TMP-SMX cannot be used, or clindamycin with primaquine as an alternative treatment), but TMP-SMX remains the standard agent for both roles.

Trimethoprim-sulfamethoxazole (Bactrim) is used for both prevention and treatment of Pneumocystis jirovecii pneumonia. It blocks sequential steps in folate synthesis, hindering DNA replication of Pneumocystis and making it highly effective. For prophylaxis in high-risk patients, a lower, ongoing dose keeps the organism from establishing infection. For treatment, a higher-dose regimen is given for about 14–21 days, with adjunctive corticosteroids if there is significant hypoxemia. Other drugs can be used as alternatives (for example, dapsone or atovaquone for prophylaxis when TMP-SMX cannot be used, or clindamycin with primaquine as an alternative treatment), but TMP-SMX remains the standard agent for both roles.

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