TitleReconsidering Empirical Cotrimoxazole Prophylaxis for Infants Exposed to HIV Infection
AuthorsGill C. J., Sabin L. L., Tham J., Hamer D. H.
PublicationBull World Health Organ. 2004 Jul; 82(4):290-7.
AbstractInfants with HIV infection are vulnerable to Pneumocystis carinii pneumonia (PCP) during their first year of life. WHO and the Joint United Nations Programme on HIV/AIDS now recommend that all children of HIV-positive mothers receive prophylactic cotrimoxazole against PCP from six weeks of age and continue this therapy until exposure through breast milk ceases-and the infant is confirmed to be HIV-negative (rarely before one year of age). Empirical prophylaxis invokes a trade-off between possible benefit to the infant versus the risk of resistance to antibiotics and antimalarials. From a critical analysis of the literature, we offer a conceptual model demonstrating how, under certain circumstances, a policy of mass cotrimoxazole prophylaxis may be counterproductive.
Related ProjectsAIDSTAR-One: AIDS Support and Technical Resources for Prevention, Care, and Treatment