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Antibiotics and HIV
Sep 26, 2008

I want to know if it is nessesary to take Sulphamethoxazole/Trimethoprim orally on a daily basis to protect yourself against possible infections. My CD4 is currently 680 and not on any ARV

Response from Dr. Frascino

Hello,

Trimethoprim/sulphamethoxazole (TMP/SMX), aka Septra or Bactrim, is generally prescribed for PCP (Pneumocystis carinii pneumonia) prophylaxis when the CD4 cell count falls to 200 or less. It can be discontinued if and when the CD4 count increased above 200 and remains there for at least three months.

TMP/SMX is also used prophylactically for prevention of toxoplasmosis when the CD4 cell count falls below 100 in toxo-seropositive patients. It too can be discontinued when the CD4 rises above 200 and remains there for at least three months.

The story regarding antibiotics for secondary prophylaxis (after someone has had a bout of toxoplasmosis disease, recovered and is ready to take medication to prevent a recurrence) is a bit more complicated. I won't go into that now, unless you have a more specific question.

Dr. Bob



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