Cotrimoxazole prophylaxis for opportunistic infections in adults with HIV

Abstract

In the trials included in the review, cotrimoxazole prophylaxis had a beneficial e ect in preventing death and illness episodes in adults with both early and advanced HIV disease. However, the wider applicability of these findings is unclear, in particular to areas with higher background bacterial resistance to cotrimoxazole. Further trials would be required in di ering settings to widen applicability.

Effect of cotrimoxazole on mortality in HIV-infected adults on antiretroviral therapy: a systematic review and meta-analysis

“…[46][47][48][49] Giving free cotrimoxazole can help increase the retention rate, 50 provide an opportunity to assess an individual's adherence to treatment before the start of ART 51 and improve survival in those not on ART. 52 Efforts to reduce early mortality in HIV-infected individuals and to increase retention rates in treatment programmes could be assisted by implementing intensified tuberculosis case-finding at every health-care visit and by providing free isoniazid to those with tuberculosis who do not have a cough, night sweats, weight loss or fever. 53 For settings in which the healthcare infrastructure is limited, WHO recommends discontinuing cotrimoxazole in adults who show good adherence to ART, have secure access to treatment and who have not had a new WHO stage 2, 3 or 4 disease event for at least 1 year.…”

Implementation of co-trimoxazole prophylaxis and isoniazid preventive therapy for people living with HIV

“…The value of co-trimoxazole in reducing the morbidity and mortality associated with HIV infection has been well established through clinical trials conducted in industrialized 5,6 and developing countries. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] CTXp is associated with a 25-46% reduction in mortality among individuals infected with HIV in sub-Saharan Africa, even in areas with high bacterial resistance to the antibiotic. These improvements in survival have been accompanied by substantial reductions in severe disease events and in the number of hospital admissions linked to invasive bacterial disease, pneumonia, malaria and diarrhoea.…”

Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality

“…Grimwade et al 24 Cotrimoxazole prophylaxis for opportunistic infections in HIV Admission Infectious…”

“…Stewart et al 37 Abba et al 20 Okebe et al 31 comparison C Duley et al 48 Kabra et al 27 Humphreys et al 33 comparison A Komossa et al 42 Dodd et al 53 Halliday et al 35 Crowther et al 54 Duley et al 47 Abalos et al 51 comparison A Rumbold et al 56 Cates et al 12 Okebe et al 31 comparison B Buppasiri et al 59 Ducharme et al 11 Martí-Carvajal et al 62 Graves et al 30 Nannini et al 13 Lucero et al 28 Walters et al 21 Peña-Rosas et al 58 Spencer et al 15 Abalos et al 51 comparison B Thomas et al 29 Nannini et al 14 Karner et al 19 Welsh et al 18 King et al 49 Al revic et al 52 Okebe et al 31 comparison D Grimwade et al 24 Rumbold et al 55 Walters et al 9 Halliday et al 36 Soares-Weiser et al 23 Makrides et al 50 Hofmeyr et al 46 Cates et al 16 Cates et al 17 Poole et al 8 Grimwade et al 25 Barr et al 10 Imdad et al 45 Okebe et al …”