Dapsone as prophylaxis for disseminated Mycobacterium avium complex infection.

Disseminated infection due to the Mycobacterium avium complex (MAC) is the most common systemic bacterial infection among patients with AIDS in developed countries. Usually, the median CD4 cell count in patients with disseminated MAC infection is in the range 10-50/mm3 (1). Rifabutine is the only recommended drug, at the present time, for prophylaxis of disseminated MAC infection (1). Dapsone, a dihydropteroate synthase inhibitor, has been shown to be active in vitro against M. tuberculosis and MAC (2, 3). In addition, dapsone is recommended for prophylaxis of Pneumocystis carinii pneumonia and neurotoxoplasmosis in association with pyrimethamine (4). Thus, dapsone is a potential agent against “multiple opportunistic pathogen prophylaxis”.