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Occupational PEP

  • 1.  Occupational PEP

    Posted 09-15-2020 15:38
    Hi all,

    I've seen a several posts on here about PEP and using newer options given nPEP and occupational PEP guidelines are form awhile ago. I'm assuming people are typically talking about nPEP.  

    The occupational PEP guidelines from 2013 still recommend RAL + FTC/TDF as preferred. Is anyone's institution using DTG or other INSTIs in place of RAL specifically for occupational PEP? If so, do you reference the nPEP guidelines or something else? How did the occupational health department respond?

    It seems kind of strange that you could have a community acquired needle stick and get DTG but if its an occupational needle stick you get RAL. 


    Eric M. Szydlowski, PharmD, MPH, AAHIVP

  • 2.  RE: Occupational PEP

    Posted 09-24-2020 09:43

    We use DTG in almost all cases. Exceptions in case of VERY early pregnancy or if the source is known to be HIV+. We don't differentiate meds based on occupational or non-occupational exposure. In fact, the workup and followup doesn't change either. The only thing that is different is who follows the patient - whether it's my clinic or the patient's employee health program. We haven't had any issues in terms of coverage or any other push back.

    Katy Garrett
    Portland ME