If a patient with PCP pneumonia has an SaO2 less than 92%, what is the recommended treatment?

In patients with Pneumocystis carinii pneumonia (PCP) who present with an oxygen saturation (SaO2) less than 92%, the addition of steroids is a crucial intervention. This is because PCP pneumonia is often associated with significant inflammatory response and lung dysfunction. Steroids are administered to reduce inflammation in the lungs, improve oxygenation, and diminish the severity of the immune response.

Research indicates that the use of adjunctive corticosteroids can significantly reduce mortality and improve clinical outcomes, particularly in cases of severe PCP where hypoxemia is present. The steroids help mitigate the effects of the immune response to the infection, allowing for better gas exchange and overall patient recovery.

The alternatives provided in the question do not address the immediate need for inflammation reduction and improved oxygenation in the context of severe hypoxia due to PCP pneumonia. Continuing outpatient therapy or switching to intravenous antibiotics alone does not directly tackle the inflammatory component contributing to the patient's respiratory distress. Discontinuing immunosuppressive therapy, while sometimes necessary in certain scenarios, does not specifically address the immediate need for corticosteroids to improve the patient's condition given their low oxygen saturation.