Antibiotics in HIV areas: New guidance

Guidance on inpatient antibiotic treatment for severely malnourished children in areas of high HIV prevalence has been changed. It is recommended that places with high HIV prevalence adapt hospital-based practices accordingly.

WHO, UNICEF and the IMTF held a technical review committee meeting in Geneva 28th-29th June 2007. The purpose of the meeting was to consider recent developments in the management of severe acute malnutrition (SAM).

An important amendment was made regarding inpatient antibiotic treatment in areas of high HIV prevalence. Since prophylactic co-trimoxazole is being widely used to reduce opportunistic respiratory infections in HIV, the Committee agreed that an alternative antibiotic (e.g. amoxicillin) should be given instead of cotrimoxazole for routine treatment of hidden infections in severely malnourished children with no complications.

The Committee also agreed that ARVs should not be started in the stabilisation phase, but that further research is needed to to identify the most opportune time.

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