The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

PCP prophylaxis during ICI

Forums General Melanoma Community PCP prophylaxis during ICI

  • Post
    kathycaribe
    Participant
      Has anyone been on PCP prophylaxis during immunotherapy with or without steroids? My MD Anderson doc put me on Bactrim and aggressively weaned me off dex and now that I’m off dex I’m thinking I no longer need the Bactrim (and this seems to be backed up by studies https://link.springer.com/article/10.1007/s00277-021-04452-9 ) and this study seems to indicate increased risk for WBRT and SRS (https://mycology.adelaide.edu.au/docs/cooley-2014-anzjm.pdf).

      The primary concern I have is developing resistance (as Bactrim is the primary treatment for PCP and PJP).

      So I;m looking for anecdotal experience of Bactrim (TMP-SMX) during ICI with or without steroid use. Thanks!

    Viewing 1 reply thread
    • Replies
        Bubbles
        Participant
          Hi Kathy,

          I do NOT presume to know all there is that is going on with your situation.  However, in all my years dealing with melanoma and melanoma patients, PCP has never been a big issue.  Unless your docs have some particular reason to think your risk for this is high, I would wish to come off Bactrim ASAP not because of a fear of developing resistance, but because (as was noted in one of the papers you sited) that we have learned that folks on antibiotics before or at the start of immunotherapy tend to have a poorer response.

          Here are lots of reports over several years (see links contained within intro) if you are interested:  https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2020/08/the-gut-microbiome-again.html

          As I note in all reports I post related to antibiotic use – when needed they are nothing short of life saving.  So, if your docs think your risk is significant enough to require them – that is one thing.  However, the data included in these many studies would certainly be something I would want to discuss.

          I wish you my best.  Celeste

          kathycaribe
          Participant
            Cutaneous
            Thanks so much! That makes a lot of sense.
        Viewing 1 reply thread
        • You must be logged in to reply to this topic.
        About the MRF Patient Forum

        The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

        The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

        Popular Topics