Document Detail

Cotrimoxazole prophylaxis in adults infected with HIV in low-income countries.
MedLine Citation:
PMID:  11964869     Owner:  NLM     Status:  MEDLINE    
Two recent placebo-controlled trials of cotrimoxazole in HIV-infected adults, conducted by independent groups but in the same city (Abidjan, Côte d'Ivoire), have both shown important positive impacts. One study where cotrimoxazole or placebo was given to tuberculosis-HIV co-infected patients showed a significant reduction in mortality; the second study with a similar protocol, in HIV-infected patients without major co-morbidity at trial entry, showed a significant reduction in morbidity but no effect on mortality. These data have been interpreted by some as conclusive enough to recommend cotrimoxazole for all people with HIV/AIDS in Africa. Others have been more cautious, noting that Abidjan has an atypically low rate of cotrimoxazole resistance among bacterial pathogens, and consider more data are needed before such a sweeping policy decision can be made. Recent data from Senegal showed no benefit but this trial, like several others, was terminated prematurely because the investigators felt it unethical to continue after the Abidjan results were released. The situation is somewhat confused and confusing. This review attempts to put the current debate into context and to review the current position of cotrimoxazole in relation to other primary prophylaxis strategies in Africa.
K Grimwade; C Gilks
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in infectious diseases     Volume:  14     ISSN:  0951-7375     ISO Abbreviation:  Curr. Opin. Infect. Dis.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2002-04-19     Completed Date:  2002-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8809878     Medline TA:  Curr Opin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  507-12     Citation Subset:  IM    
Liverpool School of Tropical Medicine, Liverpool, UK.
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MeSH Terms
Anti-Infective Agents / therapeutic use*
Bacterial Infections / prevention & control*
Clinical Trials as Topic
Drug Resistance, Bacterial
HIV Infections / complications*,  drug therapy
Trimethoprim-Sulfamethoxazole Combination / therapeutic use*
Reg. No./Substance:
0/Anti-Infective Agents; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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