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.

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... 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.