What is the role of prophylaxis against bacterial infections in patients with HIV infection?

Updated: Mar 09, 2021
  • Author: Justin R Hofmann, MD; Chief Editor: John Bartlett, MD  more...
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Prophylaxis (primary or secondary) for the following community-acquired and healthcare-associated infections is seldom indicated, although these infections are not uncommon in patients infected with HIV:

Methicillin-resistant Staphylococcus aureus folliculitis and cellulitis

Streptococcal cellulitis

Campylobacter enteritis

Salmonella enteritis and bacteremia

Shigella infection, Mycoplasma infection

Rhodococcus pneumonia

Legionella infection

Bartonella dermatitis

Gram-negative enteric urinary tract and pulmonary infections

Traveler's diarrhea

Persons infected with HIV are at high risk for sexually transmitted diseases such as syphilis, chlamydia, and gonorrhea. These should be reported to authorities and treated with documented cure and provision of counseling to avoid reinfection. Individuals exposed to a sex partner with a diagnosis of primary, secondary, or tertiary syphilis should be treated prophylactically with benzathine penicillin G 2.4 million units intramuscularly one time (AII recommendation).

Nocardia infection is rare in even late stages of AIDS, probably because it is inhibited serendipitously by P carinii pneumonia (PCP) prophylaxis with trimethoprim-sulfamethoxazole.

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