Question
Is it mandatory to take prophylaxis against PCP?
29 May 2007. Related: All topics, Opportunistic infections, Starting treatment.
Is it mandatory to take co-trimoxazole for prophylaxis against PCP?
My girlfriend is without any symptoms, but I heard in my class today that it is mandatory.
I don’t want to complicate her drug treatment with extra medicines.
Answer
Nothing in HIV treatment in mandatory (ie definitely has to be taken).
For any drug or treatment, you need to look at the risks and benefits of taking it or not taking it.
PCP prophylaxis with cotrimoxazole (Septrin) will protect your girlfriend from the risk of the pneumonia PCP. While her CD4 count is less than 200 cells/mm3 she is at higher risk of PCP, and the prophylaxis is very good and very effective.
There are many studies showing that the benefits in this case, for most people, are much greater than any risk from the additional drug.
Not using it is running a risk for getting PCP.
Cotrimoxazole is also a prophylaxis against toxoplasmosis, a serious brain infection that you are at increased risk of developing when your CD4 count is below 100 cells/mm3.
If your girlfriend is on treatment, and her CD4 count increases above 200 cells/mm3, then it is safe to stop the cotrimoxazole after talking with the doctor.
Although it is an extra pill, this is only likely to be for a short time, and it is very effective and worthwhile.
Hi
It is not unusual for some people to continue to take Septrin, but it depends on your health and treatment history.
If you have difficulty tolerating the daily dose, then speak to your doctor about whether alternative dosing is possible. For some indications there may be flexibility.
i-Base are not doctors. We don’t know your situation or why the doctor has prescribed these antibiotics based on your individual health.
Your doctor would want you to talk about any concerns with any meds.