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Bull World Health Organ. 2004 Apr;82(4):290-7.

Reconsidering empirical cotrimoxazole prophylaxis for infants exposed to HIV infection.

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1
Department of International Health, Center for International Health and Development, Boston University School of Public Health, Boston, MA, USA. cgill@bu.edu

Abstract

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.

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PMID:
15259258
PMCID:
PMC2585957
[Indexed for MEDLINE]
Free PMC Article
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