Opportunistic infection prophylaxis, with cotrimoxazole

Z29.2 + (B24)

DESCRIPTION

Primary prophylaxis reduces the probability of developing many infections, e.g.:

  • Pneumocystis pneumonia
  • bacteraemia
  • toxoplasmosis
  • cystoisosporiasis
  • bacterial pneumonia

LoEIII [27]

Indications for primary prophylaxis:

  • WHO Clinical stage II, III or IV.
  • CD4 count <200 cells/mm3.

MEDICINE TREATMENT

Prophylaxis

  • Cotrimoxazole, oral, 160/800 daily.

LoEI [28]

NOTE

Once the CD4 >200 cells/mm3 (as measured at the routine CD4 count done at 1 year on ART), discontinue prophylaxis. If the CD4 count was >200 cells/mm3 when cotrimoxazole was commenced (e.g. patients with TB) continue for 6 months.