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Concept
Post-exposure prophylaxis
Summary
Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.
In 2021, the FDA has approved bamlanivimab/etesevimab for post-exposure prophylaxis against COVID-19.
PEP is commonly and very effectively used to prevent the onset of rabies after a bite by a suspected-rabid animal, since diagnostic tools are not available to detect rabies infection prior to the onset of the nearly always-fatal disease. The treatment consists of a series of injections of rabies vaccine and immunoglobulin. Rabies vaccine is given to both humans and animals who have been potentially exposed to rabies.
Tetanus toxoid can be given in case of a suspected exposure to tetanus. In such cases, it can be given with or without tetanus immunoglobulin (also called tetanus antibodies or tetanus antitoxin). It can be given as intravenous therapy or by intramuscular injection.
The guidelines for such events in the United States for non-pregnant people 11 years and older are as follows:
AZT was approved as a treatment for AIDS in 1987. Healthcare workers would occasionally be exposed to HIV during work. Some people thought to try giving health care workers AZT to prevent seroconversion. This practice dramatically decreased the incidence of seroconversion among health workers when done under certain conditions.
Later the questions arose of whether to give HIV treatment after known exposure or high risk of exposure. Early data from pre-clinical studies established the efficacy of AZT in preventing transmission of HIV infection. AZT was also seen to reduce maternal-infant transmission of HIV in a randomized controlled trial, suggesting AZT's post-exposure prophylaxis (PEP) use. Subsequent data show combination antiretroviral therapy is significantly superior than AZT in reducing perinatal transmission rates. In addition, AZT is generally no longer recommended due to poor tolerance resulting in high rates of patient noncompliance.
Official source
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