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Post-Exposure Prophylaxis

Preventive and Immunologic Intervention

Post-exposure prophylaxis is preventive treatment given after a specific exposure to an infectious agent, intended to stop the infection from becoming established before it can take hold. Its best known use is a short course of antiretroviral drugs begun as soon as possible, and generally within 72 hours, after a possible exposure to HIV through sex, needle-stick injury or another route; the same principle underlies rabies post-exposure treatment following an animal bite, in which a course of vaccine and, in some cases, rabies immunoglobulin is given promptly to prevent the invariably fatal disease from developing. Because its effectiveness depends heavily on how soon treatment begins after exposure, post-exposure prophylaxis is treated as a time-sensitive intervention in clinical practice.

Facts
Classification
Status
Standard of Care 1
Origin Year
1885 1
Connections

Treats

HIV/AIDS, Conditions
Rabies, Conditions
Sources
1. Wikipedia: Rabies Vaccine
Wikimedia Foundation
  • History, Joseph Meister 1885
    Nine-year-old Joseph Meister (1876-1940), who had been mauled by a rabid dog, was the first human to receive this vaccine. The treatment started with a subcutaneous injection on 6 July 1885, at 8:00 pm, which was followed with 12 additional doses administered over the following 10 days.
  • Clinical use status
View the Source
Frequently Asked Questions

What is post-exposure prophylaxis?

Preventive treatment started after exposure to a pathogen to stop infection from occurring.

Post-exposure prophylaxis, also known as post-exposure prevention or PEP, is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring. It should be contrasted with pre-exposure prophylaxis, which is used before the patient has been exposed to the infective agent.

How is post-exposure prophylaxis used for rabies?

A series of rabies vaccine and immunoglobulin injections given after a suspected rabid animal bite.

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.

How soon must HIV post-exposure prophylaxis start?

Within 72 hours of exposure, after an HIV test.

For HIV, exposures that occurred 72 hours or less before beginning treatment are eligible for post-exposure prophylaxis. If the exposure occurred over 73 hours prior to treatment initiation, post-exposure prophylaxis is not indicated. Before starting, the person should be tested for HIV, and PEP should only be started if the rapid diagnostic test reveals no HIV infection or if test results are not available.
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