Spectrum: Local Antimicrobial Stewardship, for Yangon Children's Hospital

Co-trimoxazole Prophylaxis for PCP

Responsible Pathogen

Pneumocystis (Carinii) Jirovecii

Recommendations

Co-trimoxazole prophylaxis is recommended for HIV-exposed infants from 4-6 weeks of age

Should be continued until:

  • Complete cessation of breastfeeding, and

  • HIV infection has been excluded by an age-appropriate HIV test to establish final diagnosis

Co-trimoxazole prophylaxis is recommended for infants, children, and adolescents with HIV, irrespective of clinical and immune conditions

Priority should be given to:

  • All children <5 years old, regardless of CD4 cell count or clinical stage, and

  • Children with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and/or those with CD4 ≤350 cells/mm3

Co-trimoxazole prophylaxis may be discontinued for children ≥5 years of age who are:

  • Clinically stable, and/or

  • Virally suppressed on ART for at least 6 months, with a CD4 count >350 cells/mm3

Note

PCP = Pneumocystis (Carinii) Jirovecii Pneumonia