Pneumocystis remains the most common life-threatening infection among U.S. residents with advanced HIV disease. If the patient was started on PCP prophylaxis because of a low CD4 count, and the CD4 count has risen back above 200 in response to highly effective antiretroviral therapy, the PCP prophylaxis is generally continued based on the lowest nadir of the CD4 count. An alternate dosage is one TMP-SMX single strength tab qd, although the lower dose may not be as effective as the DS tabs in preventing other bacterial infections.
Many patients become intolerant of sulfa medications.
These sulfa-containing regimens are also active against toxoplasmosis. This regimen is also effective at reducing risk of toxoplasmosis activation. Observe for pallor, bluish or ashen skin coloration. Methemoglobinemia is a side effect of dapsone therapy. Screen for G6PD deficiency.