Pneumocystis carinii Pneumonia Among Renal Transplant Recipients Despite Antibiotic Prophylaxis

Pneumocystis carinii pneumonia (PCP) is a well-known opportunistic infection in renal transplant recipients; it is associated with high mortality, mostly within the first 6 months post-transplantation. The disease has been effectively prevented by routine antibiotic prophylaxis. Recently, however, we encountered three consecutive cases of PCP; one developed the disease at 8 months and another at 11 months post-transplantation. An overall assessment of a patient's degree of immunosuppression is essential when considering the duration of PCP prophylaxis. Instead of the routine regimen of 6 months, 1-year PCP prophylaxis may be required for those who are on both tacrolimus and mycophenolate mofetil.