A 28-year-old male presents with Pneumocystis jirovecii pneumonia (PCP). The drug of choice for treatment and the additional agent used when PaO2 < 70 mmHg respectively are:

• A Pentamidine; dexamethasone
• B Cotrimoxazole; prednisolone ✓
• C Cotrimoxazole; amphotericin B
• D Atovaquone; prednisolone

Explanation

High-dose cotrimoxazole (trimethoprim-sulfamethoxazole) is the drug of choice for PCP treatment. In moderate-to-severe PCP (defined by PaO2 < 70 mmHg on room air), adjunctive corticosteroids (prednisolone/prednisone) are added to reduce inflammation and improve oxygenation, thereby decreasing mortality. Pentamidine is an alternative when cotrimoxazole cannot be used; atovaquone is reserved for mild cases with cotrimoxazole intolerance.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.