What? no Bactrim?

[jyngfilm]

as stated in an earlier thread .."feeling great for bad news"    my cd4 was 154  vl 355k   had first appointment with ID this week and DR. only prescribed Tripila. I was quite surprised (and pleased) that there was no mention of a proplactic  <<< no ..I don't know how to spell it, but you know what I mean. I'm not going to second guess the dude,   But. ? do ya'll have any thoughts?   ~jordon

added Friday 1/26 >>>>>>perhaps i should add this. He did not mention Bactrim, but he did say he wants to attack with 3 meds. He wants to attack with Atripla for two weeks and make sure i handle it well. i go back in 2 weeks (Feb and depending on the tolerance, will add a third med...but he did not elaborate as to what that is.
Thank you for responses, i'll call the office monday and leave the question to him, "why no proplyactic?" ... or however you spell it. ~jordons

[ademas]

I think I would ask the doctor about it.
I had to take it for nearly 3 years--until my CD4's were over 200 for 2 labs in a row.

[Miss Philicia]

I'm quite sure my doctor made me stay on it until I was over 250 or even 275... it was 14 years ago so it's a bit fuzzy but I never dipped below 180 and I was on Bactrim at least 2 years.

[J.R.E.]

Hello Jordan,

When your T-cells fall below 200, you should be on an anti-biotic, such as bactrim.

Talk to you doctor again, and have him write you a prescription for Bactrim :


http://www.aidsmeds.com/articles/1022_6888.shtml



Ray

[Tucsonwoody]

I had a bad case of PCP last fall and was on Bactrim...then my neutrophils (part of the white blood cell) started falling until they reached zero.  So my ID doc took me off Bactrim and on to Dapsone instead even though I have really poor numbers.  She also had me drop the Valcyte I was taking to prevent CMV issues as both of them affect white blood cells and she felt it was more important to get the WB cells in a good range.

After dropping those meds and taking about 6 daily injections of Neupogen,that makes neutrophiles  (retails for about $750 a dose!!), my count went from zero to 8,000 in a week then leveled off at around 3,500 after I stopped the injections.  She told me that if my WBC counts stay stable for another few weeks I will go back to the Bactrim but since I am not showing any signs of CMV problems I won't have to take the Valcyte.

So I guess the lesson I learned is that there are other things to consider than just the PCP and CMV and other things.  Maybe there are similar reasons why Jordon isn't supposed to be on Bactrim...yet?  Was also wondering if his doctor is expecting his CD4 and VL to improve rapidly on the Atripla to the point where he wouldn't need the Bactrim?

Anyway, never hurts to ask the doctor to be sure...if just for better peace of mind.

Best of luck on the Atripla Jordon - hope it works well for you with minimal or no side effects and that you'll let us know how things go.

[JohnOso]

I'd ask the doctor too.

There may be a reason why you're not on Bactrim, but I'd sure as heck want to know why you're not on some kind of prophylaxis.

And please....you're not second guessing the dude.   It's YOUR life, not his.

My motto is.....it's not rocket science, it's just medicine.  ;-)

Take care,
John

[aztecan]

I agree, ask your doc why no prophylaxis. There may be a good reason. If there is, you need to know it.

It is your life and your health. If Bactrim won't do, there are alternatives like Dapsone.

But I would definitely speak up.

HUGS,

Mark

[Teresa]

Hubby couldn't take Bactrim so they put him on Dapsone. Hes been taking that since May. The Dr told him he would be on it till he had a CD4 of over 200 for 2 months in a row.

Like the others have said I would definitely ask the Dr about it.

Hugs
Teresa

[woodshere]

Started bactrim immediately upon getting first labs back, cd4 ct of 179, now at 264 and dr will not take me off until I go over 300.  Like everyone else says I would definately find out why you're not on something.

Woods

[Christine]

Call the doctor and ask why he did not start a pcp prophylactic. If he cops an attitude because you are questioning him, i would look for another doctor.

You need to be your own advocate. Go into your appointments with a list of questions/ concerns/ print outs of information, what ever you need to make sure all of your questions are answered.

He could have just forgotten. Doctors make mistakes, that is why it is important that we are very vigilant in our own care.

Christine

[bear60]

"He could have just forgotten. Doctors make mistakes, that is why it is important that we are very vigilant in our own care.
"  quote Christine
..............................
I just turned to my partner and asked....why do you still take Bactrim if your TCell count went over 400?  He said:  he has been taking Bactrim since 1995. ( He has been on AIDSMEDS since 1991) Before that he was allergic to Bactrim so he had been taking something else. He was DESENSITIZED to Bactrim so that he could go on it.  He said the other stuff made his pee red.
Anyway, the answer as to why he is STLL taking Bactrim is this:  he went off Bactrim a few years ago and started developing sinus infections every few months. One of those sinus infections landed him in the hospital with Pneumonia ( not PCP ).  So looks like he will always be on Bactrim.
If you're new to drugs and your immune system is in good shape it sounds to me like one has options.  If your Cd4's are under 200...its not a question....get back with your doctor right away.