When is PCP prophylaxis given?
Primary prophylaxis for Pneumocystis jirovecii pneumonia (PCP) should be initiated when the patient’s CD4 count <200cells/microL, CD4% is <14%, and patients have a detectable viral load.
Who needs PCP prophylaxis?
Indication for Primary Prophylaxis Adults and adolescents with HIV, including pregnant women and those on ART, with CD4 counts <200 cells/mm3 should receive chemoprophylaxis against PCP(AI). Persons who have a CD4 cell percentage <14% should also be considered for PCP prophylaxis (BII).
How can you prevent PCP?
The medicine most commonly used to prevent PCP is called trimethoprim/sulfamethoxazole (TMP/SMX), which is also known as co-trimoxazole and by several different brand names, including Bactrim, Septra, and Cotrim. Other medicines are available for people who cannot take TMP/SMX.
Why is bactrim used for PCP?
BactrimTM was designed by Roche Laboratories and has shown a considerable reduction of the PCP infection. It is a 5:1 ratio of sulfamethoxazole(SMZ) and trimethoprim(TMP). SMZ inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid.
What is Oi prophylaxis?
Secondary prophylaxis (called maintenance therapy in the NIH/CDC guidelines) consists of therapy given to prevent relapse of known and appropriately treated OI that have occurred before effective antiretroviral therapy (ART).
Is Pneumocystis carinii primary or secondary immunodeficiency?
Pneumocystis carinii is an important opportun- istic pathogen in patients with poor T lym- phocyte function as a result of either primary or secondary immunodeficiency.
When should PJP prophylaxis be discontinued?
Decisions to discontinue PJP prophylaxis in patients with a CD4 count <200 cells/mm(3) should be done on an individual patient basis, taking into consideration clinical factors, including ongoing adherence to ART.
How does bactrim treat PJP?
The mainstay of treatment is trimethoprim-sulfamethoxazole (Bactrim, Septra), given intravenously or orally (Table 5). Trimethoprim-sulfamethoxazole sequentially inhibits two enzymes in folate metabolism essential for DNA synthesis: dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS).