{"id":258,"date":"2019-10-09T21:23:05","date_gmt":"2019-10-09T15:53:05","guid":{"rendered":"https:\/\/medicineplexus.com\/?p=258"},"modified":"2019-10-09T21:23:05","modified_gmt":"2019-10-09T15:53:05","slug":"chemoprophylaxis","status":"publish","type":"post","link":"https:\/\/medicineplexus.com\/chemoprophylaxis\/","title":{"rendered":"Chemoprophylaxis"},"content":{"rendered":"\n<p><strong>Chemoprophylaxis<\/strong><\/p>\n\n\n\n<ul><li>administration of a <strong>medication for the purpose of preventing disease or infection<\/strong><\/li><li>The use of chemoprophylactic agents is <strong>based on knowledge of the epidemiology and clinical implications<\/strong> of the infectious diseases from which protection is sought. <\/li><li>Generally, chemoprophylaxis is <strong>taken for diseases that are common, or where the clinical impact of infection is high<\/strong>.<\/li><li>Drugs may be taken before exposure<strong> (pre-exposure prophylaxis) or<\/strong> <\/li><li>after potential exposure to an infectious agent <strong>(post-exposure prophylaxis).<\/strong><\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"670\" height=\"507\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-77.png?w=670\" alt=\"\" class=\"wp-image-259\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-77.png 670w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-77-300x227.png 300w\" sizes=\"(max-width: 670px) 100vw, 670px\" \/><\/figure>\n\n\n\n<p><strong>Latent tubercular infection\n(Chemoprophylaxis)<\/strong><\/p>\n\n\n\n<p>indicated only in subjects at high\nrisk of developing active TB, viz.:<\/p>\n\n\n\n<ul><li>Contacts of open cases who show recent Mantoux conversion.<\/li><li>Children with a sputum positive TB patient in the family.<\/li><li>Neonate of a tubercular mother.<\/li><li>Patients of leukemia, diabetes, silicosis or those receiving immunosuppressant medication or those on long-term corticosteroid therapy.<\/li><li>HIV infected contacts of sputum positive index cases.<\/li><\/ul>\n\n\n\n<p>The standard drug for\nchemoprophylaxis of TB is <strong>INH 300 mg (10\nmg\/kg in children) daily for 6 months.<\/strong><\/p>\n\n\n\n<p><strong>Suppressive\nprophylaxis<\/strong>&nbsp;\n&#8211;<strong> Malaria<\/strong><\/p>\n\n\n\n<p><strong>Chloroquine sensitive <\/strong> Plasmodium falciparum (<strong>P.f):<\/strong><\/p>\n\n\n\n<p>Chloroquine (CQ) 300 mg or 5 mg\/kg weekly.<\/p>\n\n\n\n<p>In travelers. start one week before with a\nloading dose of 10 mg\/kg and continue till one month after return from the endemic\narea. <\/p>\n\n\n\n<p>Since CQ-resistant Pf is now widespread in\nIndia\u00e0 CQ is no longer employed as prophylactic in India.<\/p>\n\n\n\n<ul><li><strong>Short-term chemoprophylaxis (less than 6 weeks)<\/strong><\/li><\/ul>\n\n\n\n<p>Doxycycline: 100 mg daily in adults, 1.5 mg\/kg body weight for children more than 8 years old.<\/p>\n\n\n\n<p>The drug started 2 days before travel and continued for 4 weeks after leaving the malarious area.<\/p>\n\n\n\n<ul><li>It is contraindicated in\npregnant women and children &lt; 8 yr.<\/li><li><strong>Long-term chemoprophylaxis (more than 6 weeks)<\/strong><\/li><\/ul>\n\n\n\n<p>Mefloquine: 5 mg\/kg body weight (up to 250 mg) weekly and should be administered 2 weeks before, during and 4 weeks after leaving the area.<\/p>\n\n\n\n<ul><li><strong>In India, the use of mefloquine for prophylaxis is not allowed among\nresidents<\/strong> but may be used by travelers for long\nterm (6 weeks to I year) prophylaxis.<\/li><\/ul>\n\n\n\n<p><strong>Chemoprophylaxis<\/strong>:<\/p>\n\n\n\n<ul><li>limited to short-term use in\nspecial risk groups, such as &#8211; nonimmune travelers, <\/li><li>nonimmune persons living in\nendemic areas for fixed periods (army units, labor forces), infants, children\nand pregnant women (falciparum malaria has serious consequences in the\npregnant).<\/li><\/ul>\n\n\n\n<p><strong>Traveler\u2019s\nDiarrhea<\/strong><\/p>\n\n\n\n<ul><li>Diarrhea is the most common\naffliction for travelers to tropical countries. <\/li><li>Between 20\u201360% of visitors to\nresource-poor countries are affected <\/li><li>Prevention is primarily through\nattention to food and hand hygiene.<\/li><li>Chemoprophylaxis, using\nrifaximin has been shown to be effective in reducing the incidence of\ntraveler\u2019s diarrhea<\/li><li>In a dose of 200 mg\/day, it\nreduced traveler\u2019s diarrhea by 72%<\/li><li>Quinolone antibiotics\n(ciprofloxacin and norfloxacin) are around 90% efficacious in preventing\ntraveler\u2019s diarrhea, but are associated with the development of resistant\norganisms, are not generally recommended as chemoprophylaxis<\/li><\/ul>\n\n\n\n<p><strong>Scrub\nTyphus<\/strong><\/p>\n\n\n\n<ul><li>Scrub typhus is caused by\nOrientia tsutsugamushi and transmitted to humans via the bite of the mite<\/li><li>These exposures can sometimes\nbe predicted and use of doxycycline in a dose of 200 mg weekly has been shown\nto be effective<\/li><\/ul>\n\n\n\n<p><strong>Leptospirosis<\/strong><\/p>\n\n\n\n<ul><li>Leptospirosis is a zoonotic\nbacterial disease transmitted to humans who come in contact with water that has\nbeen contaminated with the urine of infected animals.<\/li><li>Certain groups of people, e.g.,\nfarmers, or participants in water sporting events, are at higher risk for&nbsp; acquisition of this disease, and floods may\nbe associated with large outbreaks<\/li><li>a weekly dose of 200 mg\ndoxycycline<\/li><\/ul>\n\n\n\n<p><strong>Schistosomiasis<\/strong> <\/p>\n\n\n\n<ul><li>a common problem in returned\ntravelers, especially after exposure to freshwater in Africa<\/li><li>Artemether, a methyl ether\nderivative of qinghaosu, has anti-schistosomal properties, and because it\naffects the parasite at the larval stage was proposed as a chemoprophylactic\nagent for this disease<\/li><li>Chemoprophylaxis against\nschistosomiasis should only be considered for unavoidable exposure in high-risk\nsettings.<\/li><\/ul>\n\n\n\n<p><strong>Leprosy <\/strong><\/p>\n\n\n\n<ul><li>skin and nerve disease caused\nby Mycobacterium leprae. <\/li><li>single doses of rifampicin are\neffective at a population level and amongst close contacts (post-exposure) in\npreventing leprosy <\/li><li>Chemoprophylaxis for leprosy\nwould normally only be considered in special circumstances in travelers.<\/li><\/ul>\n\n\n\n<p><strong>Exposure to HIV<\/strong> <\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"397\" height=\"329\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-78.png?w=397\" alt=\"\" class=\"wp-image-261\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-78.png 397w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-78-300x249.png 300w\" sizes=\"(max-width: 397px) 100vw, 397px\" \/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"688\" height=\"177\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-79.png?w=688\" alt=\"\" class=\"wp-image-262\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-79.png 688w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-79-300x77.png 300w\" sizes=\"(max-width: 688px) 100vw, 688px\" \/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"356\" height=\"445\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-80.png?w=356\" alt=\"\" class=\"wp-image-263\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-80.png 356w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-80-240x300.png 240w\" sizes=\"(max-width: 356px) 100vw, 356px\" \/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"326\" height=\"431\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-81.png?w=326\" alt=\"\" class=\"wp-image-264\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-81.png 326w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2019\/10\/image-81-227x300.png 227w\" sizes=\"(max-width: 326px) 100vw, 326px\" \/><\/figure><\/div>\n\n\n\n<p><strong>The\nuse of chemoprophylaxis is limited primarily by two factors:<\/strong> <strong>risk and financial costs.<\/strong><\/p>\n\n\n\n<p><strong>Risk:\n<\/strong>All medications have the potential to cause side\neffects. In general, chemoprophylaxis should be initiated only when the\nbenefits of treatment outweigh the risks.<\/p>\n\n\n\n<p><strong>Financial\nCost:<\/strong> The cost associated with chemoprophylaxis may\nbe prohibitive, particularly when the cost of treatment is high or the\nincidence of the target disease is low. Many forms of chemoprophylaxis are\ntherefore not cost-effective.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chemoprophylaxis administration of a medication for the purpose of preventing disease or infection The use of chemoprophylactic agents is based on knowledge of the epidemiology and clinical implications of the infectious diseases from which protection is sought. Generally, chemoprophylaxis is taken for diseases that are common, or where the clinical impact of infection is high.[&#8230;]\n","protected":false},"author":3,"featured_media":261,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","footnotes":""},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/258"}],"collection":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/comments?post=258"}],"version-history":[{"count":0,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/258\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/media\/261"}],"wp:attachment":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/media?parent=258"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/categories?post=258"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/tags?post=258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}