WHO, UNAIDS and UNICEF modify recommendations for cotrimoxazole prophylaxis in children
Joint WHO/UNAIDS/UNICEF statement on use of cotrimoxazole as prophylaxis in HIV exposed and HIV infected children
Statement on use of cotrimoxazole prophylaxis
22 November 2004 -- WHO, UNAIDS and UNICEF, guided by recent evidence, have agreed to modify as an interim the current recommendations(1) for cotrimoxazole prophylaxis in children. This is based upon recent trial data from Zambia (2).
WHO/Michael Jensen 2004
These data and other new evidence will be reviewed in early 2005 by an expert committee convened to revise and update the recommendations for cotrimoxazole for adults and children. Cotrimoxazole remains important even with increasing access to ART, as it use can improve survival independently of specific HIV treatment. Current recommendations suggest it should be used before children require ARVs because it may even postpone the time at which ART needs to be started.
Prophylactic dosing with cotrimoxazole for HIV infected children with any sign or symptoms suggestive of HIV is a key intervention that should be offered as part of a basic package of care to reduce morbidity and mortality.
Cotrimoxazole prophylaxis is also a crucial potentially life saving intervention that should be given to all HIV exposed children born to HIV-infected mothers, in settings where HIV infection status cannot be reliably confirmed in the first 18 months of life.
Cotrimoxazole is a widely available antibiotic that is available in syrup and solid formulations at low-cost in most settings, including resource limited settings. It is highly effective for the treatment and prevention of Pneumocystis pneumonia. In HIV infected children it also offers protection against other infections, this remains important even with increasing access to ARV treatment.
Downloadable version of the statement [pdf 314kb]
Greater advocacy for the use of cotrimoxazole prophylaxis in children is urgently required.
WHO, UNAIDS and UNICEF modify recommendations for cotrimoxazole prophylaxis in children:
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