Secondary chemoprophylaxis in adults

Several severe or life-threatening opportunistic infections in HIVpositive patients have high recurrence rates after initial successful treatment. Lifelong secondary prophylaxis is generally recommended. The table below shows recommended drug regimens for secondary chemoprophylaxis in adults.

Pathogen

Drug regimen (first choice)

Pneumocystis carinii

trimethoprim 80 mg/sulfamethoxazole 400 mg (TMP-SMX) 2 tablets daily

Toxoplasma gondii

sulfadiazine 500 mg 4 times daily + pyrimethamine 25 mg daily OR

trimethoprim 80 mg/sulfamethoxazole 400 mg (TMP-SMX) 2 tablets daily

M avium complex

Clarithroymicin 500 mg twice daily + ethambutol 15mg/kg once daily OR

azithromycin 500 mg once daily + ethambutol 15 mg/kg once daily

Cryptococcus neoformans

fluconazole 200 mg once daily

Histoplasma capsulatum

itraconazole 200 mg twice daily

Cytomegalovirus

ganciclovir

Salmonella species (not S. typhi) bacteraemia

ciprofloxacin 500 mg twice daily for 6-8 months

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