P422 EQUAL PCP Score 2022—an ECMM score derived from current guidelines to measure QUAlity of clinical Pneumocystis Pneumonia management

POSTER SESSION 3, SEPTEMBER 23, 2022, 12:30 PM - 1:30 PM: BACKGROUND: Pneumocystis pneumonia (PCP) is a life-threatening opportunistic fungal infection requiring complex clinical management. Guidelines assist clinicians but can be challenging to comply with. OBJECTIVES: To develop a scoring tool, that facilitates and quantifies adherence to guideline recommendations for PCP. METHODS: We reviewed current PCP guidelines and determined essential recommendations for diagnosis, treatment, and follow-up. These were weighted according to their strength of recommendation and level of evidence. RESULTS: The EQUAL PCP Score 2022 consists of 22 items. For diagnosis, weight was given to bronchoalveolar lavage and immunofluorescence assays as the gold standard for sampling and analysis. Beta-D-glucan was considered of similar importance due to its high negative predictive value. Trimethoprim/sulfamethoxazole and the addition of corticosteroids in respiratory failure got 3 points respectively. Alternative approaches received less points and the use of aerosolized pentamidine was discouraged with 1 minus point. HIV-specific considerations such as the start of secondary prophylaxis were factored in as well. CONCLUSION: The EQUAL PCP Score 2022 weighs and aggregates factors recommended for optimal management of PCP. It provides a tool for antifungal stewardship as well as for measuring guideline adherence but remains to be correlated with patient outcomes.