Primary prevention
Nocardiosis is considered noncommunicable; thus, no measures are needed to prevent infection in family contacts, in nosocomial settings, or in the community.[20]
In immunocompromised patients, nocardiosis may be prevented with trimethoprim/sulfamethoxazole prophylaxis.
Secondary prevention
Because Nocardia species are ubiquitous environmental saprophytes living in soil and water, primary prevention in susceptible patients is very difficult. Trimethoprim/sulfamethoxazole prophylaxis in transplant recipients and patients with HIV with CD4 T-cell count <200 cells/mm³ may reduce the rate of Nocardia infection.[62][94] However, breakthrough cases of nocardiosis have been reported despite prophylaxis, particularly in patients receiving low-dose prophylaxis.[95][96]
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