Prophylaxis for toxoplasmosis in patients with CD4 < 100 is which drug?

Prophylaxis for toxoplasmosis in patients with CD4 < 100 is which drug?

• A. Atovaquone
• B. TMP-SMX (Bactrim)
• C. Dapsone
• D. Azithromycin

Answer: (B)

Trimethoprim-sulfamethoxazole is the drug of choice for toxoplasma prophylaxis in people with HIV who have a CD4 count below 100 and seropositive for Toxoplasma. It prevents reactivation of Toxoplasma gondii by blocking folate synthesis at two steps, effectively halting parasite replication. An added benefit is protection against Pneumocystis jirovecii pneumonia, which is a major concurrent risk in this population. If someone cannot take a sulfa drug, alternatives exist but are less reliable for toxoplasmosis prophylaxis; the other options listed do not provide adequate protection against Toxoplasma.

Trimethoprim-sulfamethoxazole is the drug of choice for toxoplasma prophylaxis in people with HIV who have a CD4 count below 100 and seropositive for Toxoplasma. It prevents reactivation of Toxoplasma gondii by blocking folate synthesis at two steps, effectively halting parasite replication. An added benefit is protection against Pneumocystis jirovecii pneumonia, which is a major concurrent risk in this population. If someone cannot take a sulfa drug, alternatives exist but are less reliable for toxoplasmosis prophylaxis; the other options listed do not provide adequate protection against Toxoplasma.