Spectral distortion due to charge sharing (CS) and pulse pileup (PP) in photon-counting detectors (PCDs) degrades the quality of PCD data. We recently proposed multi-energy inter-pixel coincidence counters (MEICC) that provided spectral cross-talk information related to CS. When PP was absent, the normalized Cramér-Rao lower bounds (nCRLBs) of 225-µm pixel PCDs with MEICC was comparable to those of 450-µm pixel PCD without MEICC. The aim of this study was to assess the performance of PCDs with MEICC in the presence of both CS and PP using computer simulations. An in-house Monte Carlo program was modified to incorporate the following four temporal elements: (1) A pulse shape with a pulse duration of 20ns, (2) delays of up to 10ns in anode arrival times when photons were incident on pixel boundaries, (3) offsets proportional to a vertical separation between the primary and secondary charge clouds at the rate of ±4ns per ±100µm, and (4) a stochastic fluctuation of anode arrival times for all of the charge clouds with a standard deviation of 2ns. We assessed the performance of five PCDs, (a)-(f), for three spectral tasks, (A)-(C): (a) The conventional PCD, (b) a PCD with MEICC, (c) a PCD with one coincidence counter (1CC), (d) a PCD with a 3×3 analog charge summing scheme (ACS), and (e) a PCD with a 3×3 digital count summing scheme (DCS); (A) conventional CT imaging with water (i.e., linear attenuation coefficient maps), (B) water-bone material decomposition, and (C) K-edge imaging with tungsten. The tube current was changed from 1mA to 1000mA and the nCRLB was assessed. The recorded count rate curves were fitted by the non-paralyzable detection model with the effective deadtime parameter. The best fit was achieved by 25.8ns for the conventional PCD, 18.6ns for MEICC and 1CC, 140.5ns for ACS, and 209.0ns for DCS. The nCRLBs were strongly dependent on count rates. MEICC provided the best nCRLBs for all of the imaging tasks over the count rate range investigated except for a few conditions such as K-edge imaging at 1mA. PP decreased the merit of MEICC over the conventional PCD in addressing CS. Nonetheless, MEICC consistently provided better nCRLBs than the conventional PCD did. The nCRLBs of MEICC were in the range of 49-58% of those of the conventional PCD for K-edge imaging, 45-76% for water-bone material decomposition, and 81-88% for the conventional CT imaging (i.e., linear attenuation coefficient maps). ACS provided better nCRLBs than the conventional PCD did only when the effect of PP was minor (e.g., when the counting efficiency of the conventional PCD was higher than 0.95 with the tube current of up to 100mA). Besides a few cases, MEICC provides the best nCRLBs for all of the tasks at all of the count rates. ACS and DCS provide better nCRLBs than the conventional PCD does only when count rates are very low.