Please note OHP guidelines allow up to 14 days to approve or deny a request. You will be notified of our decision. Authorization status can be verified by accessing the on line portal. Please allow 5 business days for processing prior to calling the office to inquire about the status of a request. Please send relevant chart notes to expedite processing. If your request is medically urgent, please indicate the reason for urgency. A scheduled appointment is not necessarily urgent. Retroactive Requests for prior authorization and referrals will be considered up to 30-days following the date of service.
TMP-SMX is the treatment of choice for PCP (AI) . 68,69 The dose must be adjusted for abnormal renal function. Multiple randomized clinical trials indicate that TMP-SMX is as effective as parenteral pentamidine and more effective than other regimens. Adding leucovorin to prevent myelosuppression during acute treatment is not recommended because efficacy is questionable and some evidence exists for a higher failure rate (AII) . 70 Oral outpatient therapy with TMP-SMX is highly effective in patients with mild-to-moderate disease (AI) . 69
If an alternate PCP prophylaxis is necessary, three options are: aerosolized pentamidine ( NebuPent ), dapsone , and atovaquone ( Mepron ). Aerosolized pentamidine is administered using a machine called a nebulizer. This turns the pentamidine liquid into a fine mist that is inhaled. Aerosolized pentamidine must be administered once a month. Dapsone is a tablet, usually taken once a day, sometimes in combination with other antibiotics. Mepron is a creamy liquid that must be taken every day. It should be taken with fatty food in order to be absorbed properly into the bloodstream. Unfortunately, none of these three antibiotics are as effective as TMP-SMX for the prevention of PCP, but do offer a significant benefit.