Co-Trimoxazole Prophylaxis
Basics
Co-Trimoxazole, commonly referred to as “Bactrim” is a fixed dose combination drug that is made up of one part Trimethoprim and 5 parts Sulfamethoxazole. For instance, Trimethoprim 80mg/Sulphamethoxazole 400mg tablets is equal to Co-Trimoxazole 80mg/400mg tablets. It is a very good drug used to treat many different infections. However, in HIV infected people it may be used as a form of prophylaxis.
Importance
It will reduce the probability of developing the following infections:
- Pneumocystis pneumonia
- Toxoplasmosis
- Bacterial pneumonia
- Bacteraemia
- Cystoisosporiasis
Indication
It is indicated in patients who have an absolute CD4 count < 200 cells/mm3 OR the patients are Clinical Stage II, III or IV.
Prophylactic Management
Co-trimoxazole 160/800 (960mg) PO daily, given until the patient CD4 count is > 200. IF the patient had ALREADY a CD4 count > 200 on initiation of the agent (maybe they were Stage II, III or IV) then you may continue the medication for 6 months.
Prophylactic Management
Patients may develop a hypersensitivity reaction = MACULOPAPULAR RASH.
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