Page 119 - HPP ANTIMICROBIAL GUIDELINE 2018

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