Page 118 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 118

Medical Retina

                                                                          Suggested Treatment
                       Infection/ Condition                                                                                         Comments
                                                              Preferred                          Alternative

                 Herpes zoster Ophthalmicus       Needs systemic therapy
                                                  Refer to Skin & Soft Tissue Infections Section


                 Ocular toxoplasmosis             Trimethoprim(TMP)/sulfamethoxazole  **Pyrimethamine 25-50mg PO q24H   Pregnancy : May consider Intravitreal
                                                  (80/400mg) TMP 10mg/kg/q24h in                                        clindamycin 1.0mg /0.1mls
                                                  2 divided doses for at least 6 weeks   PLUS

                                                                                     Azithromycin 500mg PO q24h         Systemic steroids are usually
                                                                                     OR                                 indicated in immunocompetent
                                                                                     Clindamycin 300mg PO q6H x 3-4     patients
                                                                                     weeks, then 150mg q6H PO x 3-4
                                                                                     weeks                              **Add Folinic acid 10-25mg PO q24H





                 Prophylaxis for recurrent lesions:   Trimethoprim(TMP)/sulfamethoxazole
                                                  (80/400mg)  2 tabs daily




                 Acute Retinal Necrosis           Acyclovir  10mg/kg/dose IV  q8h    ** Valacyclovir 1gm PO q8H for 6   ** Requires DG approval
                 Herpes Simplex                   (not more than 800mg) for 10-14    weeks
                                                  days                                                                  Systemic steroid is indicated
                                                                                                                        depending on location or severity of
                                                  FOLLOWED BY                                                           the infection
                                                  Acyclovir 800mg PO 5 times/day for 6
                                                  weeks






               HPP AMG                                                        Ocular Infections                                                          54
   113   114   115   116   117   118   119   120   121   122   123