Page 100 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                       Infection/ Condition                                                                                         Comments
                                                               Preferred                          Alternative

                 Extraocular CMV diseases         Ganciclovir 5mg/kg IV q12h for      Maintenance therapy with           Maintenance therapy is generally
                 (Oesophagitis, colitis, interstitial   14-21 days or until signs and   valganciclovir* 900mg PO q24h    not necessary; HAART offers best
                 pneumonitis, neurological)       symptoms have been resolved                                            hope for prevention of relapses


                 Salmonellosis (Bacteraemia)      Ceftriaxone 2gm IV q24h             Trimethoprim(TMP)/sulfamethoxazole  Duration:
                 Salmonella non-typhi                                                 (80/400mg) TMP 10mg/kg/q24h        CD4≥200: 7-14 days.
                                                                                      IV/PO in 2 divided doses           CD4 <200 and with bacteraemia:
                                                                                                                         4-6 weeks.
                                                                                                                         Longer course with debridement and
                                                                                                                         drainage needed for  persistent
                                                                                                                         bacteraemia or metastatic disease


                 Herpes Simplex Virus (HSV) Infections


                 Genital or orolabial                                                                                    Duration:
                 Mild                             Acyclovir 400mg PO q8h                                                 Genital : 5-14 days
                                                                                                                         Orolabial: 5-10 days
                 Moderate-to-severe               Acyclovir 5mg/kg IV q8h
                 mucocutaneous infections                                                                                Suppressive therapy indicated if
                                                                                                                         severe/frequent recurrences
                 Suppressive therapy              Acyclovir 400mg PO q12h                                                Duration: Continue until immunity is
                                                                                                                         restored


                 Varicella-Zoster Virus Diseases
                                                                                                                         Duration:
                 Uncomplicated/Acute Localized    Acyclovir 800mg PO 5x/day                                              Shingles : 7-10 days
                 Dermatomal                                                                                              Chickenpox : 7 days

                 Severe infection                 Acyclovir 10-15mg/kg IV q8h, then                                      Duration:
                 (CNS, ocular, disseminated)      switch to oral regime as above when                                    Shingles : 10-14 days
                                                  improved                                                               Chickenpox : 7-10 days



               HPP AMG                                                  Human Immunodeficiency Virus                                                     45
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