PJP Prophylaxis Post-Transplant — ESENeph MCQ
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Correct answer: B — Daily trimethoprim-sulfamethoxazole for 3 to 6 months
The best answer is “Daily trimethoprim-sulfamethoxazole for 3 to 6 months”. KDIGO recommends daily trimethoprim-sulfamethoxazole for 3-6 months after kidney transplantation. It also protects against several bacterial infections; alternative agents are used when contraindicated. “No prophylaxis unless Pneumocystis infection develops” is less appropriate because early post-transplant immunosuppression creates a preventable high-risk period “Fluconazole for 3 to 6 months” is less appropriate because fluconazole targets susceptible fungi but not Pneumocystis jirovecii prophylaxis “Valganciclovir for 3 to 6 months as the Pneumocystis agent” is less appropriate because valganciclovir is used for CMV prevention, not PJP prophylaxis “A single perioperative dose of trimethoprim-sulfamethoxazole” is less appropriate because one dose does not cover the prolonged early immunosuppressed period
Reference: KDIGO kidney transplant recipient guideline: https://kdigo.org/wp-content/uploads/2022/09/KDIGO-2009-Transplant-Recipient-Guideline-English.pdf