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Indications:
- All HIV exposed infants from 4 weeks of age (Infants born to HIV infected mothers) till prove to be negative.
- All HIV infected asymptomatic infants till 1 year of age
- All symptomatic HIV infected children
- After initial treatment for PCP
- All HIV infected children with CD 4 % less than 15% irrespective of symptoms
How long to give prophylaxis
- In HIV exposed infants till proved to be HIV negative
- All HIV infected children who are symptomatic should receive till started on ART and there is evidence of immune reconstitution. i.e., in a CD 4 count of > 15% on 2 occasions no less than 3 months apart. If CD 4 count not available, then stop TMP/SMX only after 6 months of ART with clinical evidence of immune reconstitution.
- All HIV infected children who do not receive ART and are symptomatic – prophylaxis should be continued indefinitely.
Drugs & Dosage for PCP prophylaxis
Drugs |
Dosage |
Remarks |
TMP/SMX |
- 150 mg of TMPm2/day PO BD on alternate day
- 5 mg/kg of TMP/day PO HS daily |
Drug of choice |
Dapsone |
2 mg/kg/day PO (max 100 mg/day) |
Alternative drug |
Pentamidine |
300 mg inhaler every 28 days
OR
4 mg/kg/day IV OD every 2-4 weeks |
Alternate drug for
children over 5 years of age |
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