Impact of prolonged co-trimoxazole prophylaxis on colonization with antibiotic resistant bacteria in persons newly diagnosed with HIV-infection: CoTrimResist—a randomized placebo-controlled trial - Takeaways - MDSpire
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Effect of Extended Co-trimoxazole Prophylaxis on Antibiotic-Resistant Bacterial Colonization in People Newly Diagnosed with HIV: The CoTrimResist Randomized, Placebo-Controlled Trial

  • By

  • Bjørn Blomberg

  • Joel Manyahi

  • Sabrina John Moyo

  • Marit Tellevik

  • Said Aboud

  • Kanika Kuwelker

  • Helene Heitmann Sandnes

  • Rolv Terje Lie

  • Nina Langeland

  • October 20, 2026

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  • 1

    CoTrimResist is a double-blind, randomized, placebo-controlled trial of 1 year of daily co-trimoxazole prophylaxis in adults newly diagnosed with HIV in Dar es Salaam, Tanzania.

  • 2

    Eligibility includes nonpregnant adults older than 18 years with a first HIV-positive screening test and CD4 count ≥350 cells/µL. Known co-trimoxazole allergy is an exclusion criterion.

  • 3

    The trial assesses carriage of extended-spectrum beta-lactamase-producing E. coli and Klebsiella species, methicillin-resistant Staphylococcus aureus, penicillin-nonsusceptible pneumococci, and vancomycin-resistant enterococci.

  • 4

    Participants, clinical staff, study personnel, data managers, and statisticians are blinded to treatment assignment. The allocation list remains concealed from study staff until follow-up is complete.

  • 5

    The study examines concerns that prolonged co-trimoxazole use may select for drug-specific resistance and cross-resistance because multiple resistance genes can coexist on plasmids.

Original Source(s)

Impact of prolonged co-trimoxazole prophylaxis on colonization with antibiotic resistant bacteria in persons newly diagnosed with HIV-infection: CoTrimResist—a randomized placebo-controlled trial

  • by Bjørn Blomberg, Joel Manyahi, Sabrina John Moyo, Marit Tellevik, Said Aboud, Kanika Kuwelker, Helene Heitmann Sandnes, Rolv Terje Lie, Nina Langeland

  • October 20, 2026

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