title: Impact of cotrimoxazole prophylaxis on the health of breast-fed, HIV-exposed, HIV-negative infants in a resource-limited setting.
abstract: WHO guidelines recommend cotrimoxazole prophylaxis (CTXP) in all HIV-exposed negative infants who are still breastfeeding. This is based on the evidence of efficacy in HIV-infected infants, but there is no evidence of benefit in HIV-negative, breast-fed infants. We assessed the impact of CTXP on diarrhoeal and respiratory morbidity in breast-fed, HIV-exposed negative infants in a community programme. CTXP for more than 60 days showed no consistent evidence of benefit for incidence of lower respiratory tract infection [incidence rate ratio (IRR) 0.71, 95% confidence interval (CI) 0.39-1.26; P = 0.241] but an increased incidence of diarrhoea (IRR = 1.38, 95% CI 0.98-1.94; P = 0.065). The guidelines should be reconsidered by conducting a randomized control trial.
authors.affiliation: Department Paediatrics and Child Health, School of Family and Public Health, University of KwaZulu-Natal, Durban, South Africa. coutsoud@ukzn.ac.za
authors.forename: Anna
authors.initials: A
authors.lastname: Coutsoudis
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Kindra
authors.forename: Tonya
authors.initials: T
authors.lastname: Esterhuizen
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination