Does trimethoprim-sulfamethoxazole prophylaxis for HIV induce bacterial resistance to other antibiotic classes? Results of a systematic review

Euphemia L Sibanda, Ian V D Weller, James G Hakim, Frances M Cowan, Euphemia L Sibanda, Ian V D Weller, James G Hakim, Frances M Cowan

Abstract

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis has long been recommended for immunosuppressed HIV-infected adults and children born to HIV-infected women. Despite this, many resource-limited countries have not implemented this recommendation, partly because of fear of widespread antimicrobial resistance not only to TMP-SMX, but also to other antibiotics. We aimed to determine whether TMP-SMX prophylaxis in HIV-infected and/or exposed individuals increases bacterial resistance to antibiotics other than TMP-SMX.

Methods: A literature search was conducted in Medline, Global Health, Embase, Web of Science, ELDIS, and ID21.

Results: A total of 501 studies were identified, and 17 met the inclusion criteria. Only 8 studies were of high quality, of which only 2 had been specifically designed to answer this question. Studies were classified as (1) studies in which all participants were infected and/or colonized and in which rates of bacterial resistance were compared between those taking or not taking TMP-SMX and (2) studies comparing those who had a resistant infection with those who were not infected. Type 1 studies showed weak evidence that TMP-SMX protects against resistance. Type 2 studies provided more convincing evidence that TMP-SMX protects against infection.

Conclusion: There was some evidence that TMP-SMX prophylaxis protects against resistance to other antibiotics. However, more carefully designed studies are needed to answer the question conclusively.

Figures

Figure 1.
Figure 1.
Process for identification of eligible publications.
Figure 2.
Figure 2.
Meta-analysis of MRSA cohort studies.

References

    1. Anglaret X, Chene G, Attia A, et al. Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d'Ivoire: a randomised trial. Cotrimo-CI Study Group. Lancet. 1999;353:1463–8.
    1. Wiktor SZ, Sassan-Morokro M, Grant AD, et al. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Cote d'Ivoire: a randomised controlled trial. Lancet. 1999;353:1469–75.
    1. Chintu C, Bhat GJ, Walker AS, et al. Co-trimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind randomised placebo-controlled trial. Lancet. 2004;364:1865–71.
    1. Walker AS, Ford D, Gilks CF, et al. Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort. Lancet. 2010;375:1278–1286.
    1. World Health Organisation. Provisional WHO/UNAIDS Secretariat recommendations on the use of cotrimoxazole prophylaxis in adults and children living with HIV/AIDS in Africa. Geneva, Switzerland: WHO/UNAIDS, 2000.
    1. World Health Organisation. Guidelines on co-trimoxazole prophylaxis for HIV related infections among chidren, adolescents and adults: recommendations for a public health approach. Switzerland: WHO; 2006.
    1. Zachariah R, Harries AD, Luo C, Bachman G, Graham SM. Scaling-up co-trimoxazole prophylaxis in HIV-exposed and HIV-infected children in high HIV-prevalence countries. Lancet Infect Dis. 2007;7:686–93.
    1. World Health Organisation. Taking Stock: HIV in children. Geneva: Word Helath Organisation; 2006.
    1. Zimbabwe Ministry of Health and Child Welfare. Zimbabwe Ministry of Health and Child Welfare: HIV Estimates Report 2007. Estimates Reports. Harare: Government of Zimbabwe; 2008.
    1. Ryan M, Griffin S, Chitah B, et al. The cost-effectiveness of cotrimoxazole prophylaxis in HIV-infected children in Zambia. AIDS. 2008;22:749–57.
    1. Yazdanpanah Y, Losina E, Anglaret X, et al. Clinical impact and cost-effectiveness of co-trimoxazole prophylaxis in patients with HIV/AIDS in Cote d'Ivoire: a trial-based analysis. AIDS. 2005;19:1299–308.
    1. Badri M, Ehrlich R, Wood R, Maartens G. Initiating co-trimoxazole prophylaxis in HIV-infected patients in Africa: an evaluation of the provisional WHO/UNAIDS recommendations. AIDS. 2001;15:1143–8.
    1. Nunn AJ, Mwaba P, Chintu C, Mwinga A, Darbyshire JH, Zumla A. Role of co-trimoxazole prophylaxis in reducing mortality in HIV infected adults being treated for tuberculosis: randomised clinical trial. BMJ. 2008;337:a257.. . Accessed 2 February 2011.
    1. Thera MA, Sehdev PS, Coulibaly D, et al. Impact of trimethoprim-sulfemethoxazole prophylaxis on falciparum malaria infection and disease. J Infect Dis. 2005;192:1823–9.
    1. Gill CJ, Sabin LL, Tham J, Hamer DH. Reconsidering empirical cotrimoxazole prophylaxis for infants exposed to HIV infection. Bull World Health Organ. 2004;82:290–7.
    1. Hamel MJ, Greene C, Chiller T, et al. Does cotrimoxazole prophylaxis for the prevention of HIV-associated opportunistic infections select for resistant pathogens in Kenyan adults? Am J Trop Med Hyg. 2008;79:320–30.
    1. Gill CJ, Mwanakasale V, Fox MP, et al. Effect of presumptive co-trimoxazole prophylaxis on pneumococcal colonization rates, seroepidemiology and antibiotic resistance in Zambian infants: a longitudinal cohort study. Bull World Health Organ. 2008;86:929–38.
    1. National Institute for Health and Clinical Excellence (NICE) NICE: Guideline Development Methods (Appendices): D Methodology checklist: cohort studies. Available at: . Accessed 11 April 2009.
    1. National Institute for Health and Clinical Excellence (NICE) NICE: Guideline Development Methods (Appendices): E Methodology checklist: case–control studies. Available at: . Accessed 11 April 2009.
    1. Crum-Cianflone NF, Burgi AA, Hale BR. Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons. Int J STD AIDS. 2007;18:521–26.
    1. Jordano Q, Falco V, Almirante B, et al. Invasive pneumococcal disease in patients infected with HIV: still a threat in the era of highly active antiretroviral therapy. Clin Infect Dis. 2004;38:1623–8.
    1. Madhi SA, Petersen K, Madhi A, Wasas A, Klugman KP. Impact of human immunodeficiency virus type 1 on the disease spectrum of Streptococcus pneumoniae in South African children. Pediatr Infect Dis J. 2000;19:1141–7.
    1. Mathews WC, Caperna JC, Barber RE, et al. Incidence of and risk factors for clinically significant methicillin-resistant Staphylococcus aureus infection in a cohort of HIV-infected adults. Acquir Immune Defic Syndr. 2005;40:155–60.
    1. Drapeau CMJ, Angeletti C, Festa A, Petrosillo N. Role of previous hospitalization in clinically-significant MRSA infection among HIV-infected inpatients: results of a case-control study. Infect Dis. 2007;7:36 (. Accessed 4 February 2011) BMC.
    1. Lee NE, Taylor MM, Bancroft E, et al. Risk factors for community-associated methicillin-resistant Staphylococcus aureus skin infections among HIV-positive men who have sex with men. Clin Infect Dis. 2005;40:1529–34.
    1. Meynard JL, Barbut F, Blum L, et al. Risk factors for isolation of Streptococcus pneumoniae with decreased susceptibility to penicillin G from patients infected with human immunodeficiency virus. Clin Infect Dis. 1996;22:437–40.
    1. Tumbarello M, de Gaetano Donati K, Tacconelli E, et al. Risk factors and predictors of mortality of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in HIV-infected patients. J Antimicrob Chemother. 2002;50:375–82.
    1. Achenbach C, Flores E, Ferrell P, Pitrak D, Weber SG. Prevalence of and risk factors for colonization with vancomycin-resistant enterococcus among human immunodeficiency virus-positive outpatients. Infect Control Hosp Epidemiol. 2006;27:102–4.
    1. Cenizal MJ, Hardy RD, Anderson M, Katz K, Skiest DJ. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in HIV-infected ambulatory patients. J Acquir Immune Defic Syndr. 2008;48:567–71.
    1. Cotton MF, Wasserman E, Smit J, Whitelaw A, Zar HJ. High incidence of antimicrobial resistant organisms including extended spectrum beta-lactamase producing enterobacteriaceae and methicillin-resistant Staphylococcus aureus in nasopharyngeal and blood isolates of HIV-infected children from Cape Town, South Africa. BMC Infect Dis. 2008;8:40 (). Accessed 4 February 2011.
    1. Villacian JS, Barkham T, Earnest A, Paton NI. Prevalence of and risk factors for nasal colonization with Staphylococcus aureus among human immunodeficiency virus-positive outpatients in Singapore. Infect Control Hosp Epidemiol. 2004;25:438–40.
    1. Zar HJ, Hanslo D, Hussey G. The impact of HIV infection and trimethoprim-sulphamethoxazole prophylaxis on bacterial isolates from children with community-acquired pneumonia in South Africa. Trop Pediatr. 2003;49:78–83.
    1. Pemba L, Charalambous S, von Gottberg A, et al. Impact of cotrimoxazole on non-susceptibility to antibiotics in Streptococcus pneumoniae carriage isolates among HIV-infected mineworkers in South Africa. J Infect. 2008;56:171–8.
    1. Martin JN, Rose DA, Hadley WK, Perdreau-Remington F, Lam PK, Gerberding JL. Emergence of trimethoprim-sulfamethoxazole resistance in the AIDS era. J Infect Dis. 1999;180:1809–18.
    1. Marinda E, Humphrey JH, Iliff PJ, et al. Child mortality according to maternal and infant HIV status in Zimbabwe. Pediatr Infect Dis J. 2007;26:519–26.
    1. McNally LM, Jeena PM, Gajee K, et al. Effect of age, polymicrobial disease, and maternal HIV status on treatment response and cause of severe pneumonia in South African children: a prospective descriptive study. Lancet. 2007;369:1440–51.
    1. Teuber M, Meile L, Schwarz F. Acquired antibiotic resistance in lactic acid bacteria from food. ntonie Van Leeuwenhoek. 1999;76:115–37.
    1. Hidron AI, Kourbatova EV, Halvosa JS, et al. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage. Clin Infect Dis. 2005;41:159–66.

Source: PubMed

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