Introduction Opportunistic infections, viral, bacterial, fungal and parasitic are the most common cause of morbidity and mortality in HIV patients. Of the different antibiotics used for bacterial respiratory tract infections, cotrimoxazole appears to be a drug of choice in most developing countries because of its very low cost. Studies in Ivory Coast showed that cotrimoxazole decreased hospitalisation in 50% of all HIV patients and decreased mortality by 50% when given to HIV positive TB patients. Recently Streptococus pneumoniae, Haemophilus influenzae, Moraxalla catarrhalis have become increasingly resistant to antibiotics and the rates vary between countries. Aware of the public health importance, the drug resistance patterns on bacterial respiratory opportunistic pathogens from HIV patients in Lagos were studied for better management of HIV in Nigeria.

Methods 310 sputum samples were collected from HIV patients presenting with respiratory complaints at ART clinics in Lagos after due informed consent from the patients and processed in the laboratory within 4 h using standard microbiological methods.

Results 57.1% patients were females, 70.5% of the samples grew bacterial pathogens mainly Morascella catarrholis 25.1%, Staphylococcus aureus 9.2%, Streptococcus pneumoniae 8.3%, Pseudomonas aeruginosa 7.3%, coaggulase negative staphylococcus 5.3%. Some Enterobactereciae were isolated and 86.8% of isolates were susceptible to ofloxacin, 80.2% to ciprofloxacin and 12.8% to cotrimoxazole.

Conclusion Pathogens isolated were susceptible to ofloxacin, ciprofloxacin but highly resistant to cotrimoxazole, an affordable and widely used drug in African countries. This poses a challenge to management of HIV in Nigeria.