An ongoing dialogue on HIV/AIDS, infectious diseases,
October 21st, 2008
Back to School, Day 4: PEP and More PEP
After a lecture on HIV for Primary Care Providers in our course last week, the most controversial topic was, not surprisingly, the use of post-exposure prophylaxis (PEP) for both occupational and non-occupational exposures. And today, after an entire lecture on PEP to a group of HIV providers in our AIDS course, again the subject drew numerous questions — and strong opinions — from the audience.
Since this is a relatively data-free zone, one turns to the guidelines for advice. But not surprisingly, they offer tons of wiggle room for a clinician to do pretty much anything he or she wants in all but the most florid exposures or non-exposures.
(Can there be a florid non-exposure?)
So here’s a case we just posted on AIDS Clinical Care. (Drawn from real life, of course.) Emergency room resident sticks herself with a needle while suturing a patient’s wound, a patient who’s HIV positive with an undetectable viral load on treatment. Oh, and the resident is pregnant.
To give PEP or not to give PEP?
Categories: Antiretroviral Rounds, Health Care, HIV, Infectious Diseases, Medical Education, Patient Care
Tags: blood-borne pathogens, HIV, medical resident, occupational exposure, PEP, post-exposure prophylaxis
You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
Paul E. Sax, MD
Learn more about HIV and ID Observations.
Follow HIV and ID Observations Posts via Email
- Endless Recertification in Medicine — Some Thoughts About the Tests We Take
- My Vote for the Weirdest Antibiotic on the Planet
- Long-Acting Cabotegravir-Rilpivirine for People Not Taking Oral Therapy — Time to Modify Treatment Guidelines?
- Learning the Names of HIV Drugs Is Horribly Difficult — Here’s Why
- Really Rapid Review — Brisbane IAS 2023
- ID Cartoon Caption Contest (125)
- ID Cartoon Caption Contest #2 Winner — and a New Contest for the Holidays (92)
- Dear Nation — A Series of Apologies on COVID-19 (80)
- How to Induce Rage in a Doctor (77)
- IDSA’s COVID-19 Treatment Guidelines Highlight Difficulty of “Don’t Just Do Something, Stand There” (74)
- Missed Chances for Screening in Persons Newly Diagnosed with HIV: New York City, 2018–2022
- Arboviral Disease Surveillance in the U.S.
- Observations from ID and Beyond: Long-Acting Cabotegravir-Rilpivirine for People Not Taking Oral Therapy — Time to Change Treatment Guidelines?
- Risk for C. difficile Infection Varies Widely with Choice of Antibiotic
- Mpox in Persons with Previous Infection or Vaccination
- Abacavir AIDS antibiotics antiretroviral therapy ART atazanavir baseball Brush with Greatness CDC C diff COVID-19 CROI darunavir dolutegravir elvitegravir etravirine FDA HCV hepatitis C HIV HIV cure HIV testing ID fellowship ID Learning Unit Infectious Diseases influenza Link-o-Rama lyme disease MRSA PEP Policy PrEP prevention primary care raltegravir Really Rapid Review resistance Retrovirus Conference rilpivirine sofosbuvir TDF/FTC tenofovir Thanksgiving vaccines zoster