Inpharma 1238 - 20 May 2000 Recommended prophylaxis against opportunistic infections ‘Understanding and applying measures to prevent opportunistic infections has had, and will continue to have, a critical role in the treatment of patients with HIV infection’, say Drs Joseph Kovacs and Henry Masur from the National Institutes of Health, Bethesda, Maryland, US. Drs Kovacs and Masur make a number of recommendations for such prophylaxis, expanding on the guidelines issued by the US Public Health Service and the Infectious Diseases Society of America. * • Cotrimoxazole [trimethoprim/sulfamethoxazole] is the first choice for primary prophylaxis against Pneumocystis carinii pneumonia (PCP) and toxoplasmosis. Prophylaxis against PCP is indicated for patients with CD4+ cell counts of < 200/mm 3 and patients with oral candidiasis; prophylaxis against toxoplasmosis is indicated for patients with CD4+ cell counts of < 100/mm 3 . • A number of combinations of antituberculars may be used as prophylaxis against tuberculosis (TB); prophylaxis is indicated for patients with a positive tuberculin test who have not previously been treated for TB or patients who have recently been exposed to someone with active TB. • Azithromycin and clarithromycin are the preferred agents for prophylaxis against Mycobacterium avium complex, which is indicated for patients with CD4+ cell counts of < 50/mm 3 . Drs Kovacs and Masur also discuss the issues of secondary prophylaxis, drug interactions and discontinuation of prophylaxis. * See Inpharma 1203: 2, 4 Sep 1999; see Inpharma 1203 p2; 800787561 Kovacs JA, et al. Drug therapy: prophylaxis against opportunistic infections in patients with human immunodeficiency virus infection. New England Journal of Medicine 342: 1416-1429, 11 May 2000 800820448 1 Inpharma 20 May 2000 No. 1238 1173-8324/10/1238-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Recommended prophylaxis against opportunistic infections

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Inpharma 1238 - 20 May 2000

Recommended prophylaxis againstopportunistic infections

‘Understanding and applying measures to preventopportunistic infections has had, and will continue tohave, a critical role in the treatment of patients with HIVinfection’, say Drs Joseph Kovacs and Henry Masur fromthe National Institutes of Health, Bethesda, Maryland,US.

Drs Kovacs and Masur make a number ofrecommendations for such prophylaxis, expanding onthe guidelines issued by the US Public Health Serviceand the Infectious Diseases Society of America.*

• Cotrimoxazole [trimethoprim/sulfamethoxazole] isthe first choice for primary prophylaxis againstPneumocystis carinii pneumonia (PCP) andtoxoplasmosis. Prophylaxis against PCP is indicatedfor patients with CD4+ cell counts of < 200/mm3

and patients with oral candidiasis; prophylaxisagainst toxoplasmosis is indicated for patients withCD4+ cell counts of < 100/mm3.

• A number of combinations of antituberculars may beused as prophylaxis against tuberculosis (TB);prophylaxis is indicated for patients with a positivetuberculin test who have not previously been treatedfor TB or patients who have recently been exposedto someone with active TB.

• Azithromycin and clarithromycin are the preferredagents for prophylaxis against Mycobacterium aviumcomplex, which is indicated for patients with CD4+cell counts of < 50/mm3.

Drs Kovacs and Masur also discuss the issues ofsecondary prophylaxis, drug interactions anddiscontinuation of prophylaxis.* See Inpharma 1203: 2, 4 Sep 1999; see Inpharma 1203 p2;800787561

Kovacs JA, et al. Drug therapy: prophylaxis against opportunistic infections inpatients with human immunodeficiency virus infection. New England Journal ofMedicine 342: 1416-1429, 11 May 2000 800820448