First-line prophylaxis against Pneumocystis carinii in an HIV-positive patient is which of the following?

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Multiple Choice

First-line prophylaxis against Pneumocystis carinii in an HIV-positive patient is which of the following?

Explanation:
Trimethoprim-sulfamethoxazole is the preferred first-line prophylaxis against Pneumocystis jirovecii pneumonia in HIV infection. It provides reliable protection against PCP and also offers added protection against Toxoplasma gondii encephalitis when the CD4 count is very low. It’s effective, well tolerated for many patients, inexpensive, and widely available, making it the standard choice. Alternatives like aerosolized pentamidine can be used if TMP-SMX isn’t tolerated, but they’re generally less convenient and may be less effective; dapsone is another option but carries risks such as hemolysis in G6PD deficiency; azithromycin has no activity against Pneumocystis, so it isn’t used for PCP prevention.

Trimethoprim-sulfamethoxazole is the preferred first-line prophylaxis against Pneumocystis jirovecii pneumonia in HIV infection. It provides reliable protection against PCP and also offers added protection against Toxoplasma gondii encephalitis when the CD4 count is very low. It’s effective, well tolerated for many patients, inexpensive, and widely available, making it the standard choice. Alternatives like aerosolized pentamidine can be used if TMP-SMX isn’t tolerated, but they’re generally less convenient and may be less effective; dapsone is another option but carries risks such as hemolysis in G6PD deficiency; azithromycin has no activity against Pneumocystis, so it isn’t used for PCP prevention.

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