Interventions to prevent opportunistic infections in immunocompromised patients

Interventions to prevent opportunistic infections in immune compromise are:

• primary antimicrobial prophylaxis—aims to prevent a new infection (eg Pneumocystis jirovecii pneumonia [PJP]) in patients identified as high risk
• immunisation—aims to prevent a vaccine-preventable infection (eg influenza, hepatitis B). For details, see the Australian Immunisation Handbook [URL]
• treatment of latent infection—aims to prevent reactivation of infection (eg tuberculosis)
• pre-emptive (or early) treatment—aims to prevent occurrence of active disease by screening asymptomatic patients for an infection and starting antimicrobial treatment before the patient displays features of disease (eg cytomegalovirus)
• secondary prophylaxis (or maintenance therapy)—aims to prevent recurrence after initial treatment of an infection (eg PJP).

Primary antimicrobial prophylaxis of opportunistic infections is covered in this topic, with some discussion of treatment of latent infection and pre-emptive treatment. For secondary prophylaxis, refer to the relevant clinical topic (eg Pneumocystis jirovecii pneumonia).

See the guidelines listed in Further reading for details about nonpharmacological preventive measures such as screening before starting immunosuppressive therapy, infection control measures, and advice about diet and other lifestyle factors.