Prophylaxis

This is essential after an episode of PCP, or when CD4 positive counts drop below 200/microlitre or less than 20% of total lymphocyte count.

The most effective agents are a combination of Trimethoprim and Sulphamethoxazole (co-trimoxazole). If this is poorly tolerated however aerosolized pentamidine or dapsone may be used (note that dapsone may cause haemolytic anaemia and is contra-indicated in G6PD deficiency).

Reference

1. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. AIDS info, 2019
2. National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Pneumocystis pneumonia. Sep 2024 [internet publication].