Reconsidering empirical cotrimoxazole prophylaxis for infants exposed to HIV infection
| Autor: | Gill Christopher J., Sabin Lora L., Tham Joseph, Hamer Davidson H. |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Trimethoprim-sulfamethoxazole combination/therapeutic use
Trimethoprim-sulfamethoxazole combination/adverse effects Pneumonia Pneumocystis/drug therapy HIV infections/complications AIDS-related opportunistic infections/drug therapy Disease transmission Vertical Drug resistance Microbial Sulfadoxine/pharmacology Pyrimethamine/pharmacology Infant Risk assessment Meta-analysis Models Theoretical Africa Public aspects of medicine RA1-1270 |
| Zdroj: | Bulletin of the World Health Organization, Vol 82, Iss 4, Pp 290-298 (2004) |
| Druh dokumentu: | article |
| ISSN: | 0042-9686 |
| Popis: | Infants 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. |
| Databáze: | Directory of Open Access Journals |
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