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.
my cd4 cell count is 241 and i was asked to take the septrin daily for the rest of my life. It always makes me bloated and i have to drink lots of water otherwise i get headaches. Should i stop taking daily and take maybe 3 times a week.
Hello Chiabi,
In the British HIV Association (BHIVA) guidelines dapsone or pentamidine are recommended as alternatives to cotrimoxazole for PCP prophylaxis.
Sir;
What are the alternatives to cotrimoxazole in case of allergy, in PCP prophylaxis?
Thanks
Septrin will hardly help with this kind of problem. There may be many reasons for the pimples, like hormonal disbalance, certain infections, etc. This needs to be seen by a doctor to find out the exact reason and only then an appropriate medication can be prescribed.
I have a really rough face and am not sure how to call it-a bad case of pimples or something else, but it worries me and I am concerned. I have discussed it with a friend and she recommended that I take two tablets of septrin daily. I
You doctor may have prescribed Septrin for other reasons.
As with the situations above, the first thing to do is to ask your doctor about why this important for your particular situation.
Sometimes Septrin (cotrimoxazole) can have a protective effect at higher CD4 counts in people who are not on HIV treatment, particularly in countries where there is a higher risk of bacterial infections.
My CD4 count is 500 and i have been advised to take Septrin daily. Is it wrong?
When I stop I always feel like my bones are burning and i get pimples on my face.
Hi Pauline
Co-trimoxazole (Septrin) is an antibiotic. As well as protecting against PCP it can help with other diseases, and is also a prophylaxis again toxoplasmosis.
Unless you have had PCP or other illness that Septrin is being used to treat, most people stop using Septrin as a prophylaxis a few months after their CD4 count has increased above 200 cells/mm3.
Unlike ARVs, it is not a treatment that you need to take for life – so long as your CD4 count stays above 200.
Taking meds with water is usually to increase absorption – to make your your body gets the right dose. If this is causing constipation – which is not commonly reported – then perhaps using a mild laxitive until your CD4 count is over 200, may help.
I take Septrin (2 tablets everyday) plus my ARVs, because I was asked to by the government hospital after some research.
I now know it is a prophylaxis against PCP, but what I would like to know are there any other benefits?
Am I suppose to take for life like the ARV’s?
Under what group of medicines is it classified under e.g. is it an antibiotic? or antibacterial? w
Why does my pharmacist ask me to drink alot of water? I notice am always constipated is it because of the Septrin?
Having had some personal experience of taking co-trimoxazole (Septrin), I would suggest that you also need to be looking beyond the immediate prophylactic benefits of the drug.
Knowing that your CD4 levels are so low that you are in real danger of developing AIDS defining illnesses is a considerable additional stress in what is already likely to be a stressful situation.
Knowing that you have the added assistance of Septrin (which often only needs to be taken three times a week) can have quite a dramatic beneficial effect on levels of stress .. and therefore mood and general quality of life.