What is the role of pharmacologic prophylaxis in the treatment of severe combined immunodeficiency (SCID)?

Updated: Apr 28, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Harumi Jyonouchi, MD  more...
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Because T cells are absent, dysfunctional, or both, administer P jiroveci (carinii) pneumonia (PCP) prophylaxis to all patients until T-cell function is restored by means of BMT or other therapy. Trimethoprim-sulfamethoxazole is the drug of choice and can be administered in a patient who is older than 2 months or in whom neonatal jaundice is no longer a concern.

In individual cases, prophylaxis with antiviral agents (eg, acyclovir) or antibiotics also may be appropriate. After exposure to varicella zoster virus (VZV), prophylaxis with varicella zoster immune globulin (VZIG) should be administered within 48 hours, if possible; VZIG may be efficacious up to 96 hours after exposure. Beyond that interval, acyclovir has been administered and may prevent or modify the severity of VZV infection.

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