Page 66 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition
Spinal epidural abscess
Viral encephalitis
Herpes simplex
Varicella zoster
Cytomegalovirus (CMV)
Induction phase:
Maintenance phase:
Cryptococcal meningitis
(non-HIV, non-transplant patient)
Induction therapy:
Consolidation therapy:
Maintenance therapy:
HPP AMG
Preferred
Ceftriaxone 2 gm IV q12h
Acyclovir 500mg IV q8h for 14 days
Ganciclovir 5mg/kg IV q12h for
14-21 days.
Ganciclovir 5mg/kg IV q24h for 6
months depending on severity of
disease, time to response and end
organ involvement. May switch to
oral valganciclovir if available
Amphotericin B 0.7-1.0mg/kg/24h IV
PLUS
Flucytosine 100mg/kg/24h PO in 4
divided doses for 4-6 weeks
Fluconazole 400-800mg PO q24h for
8 weeks
Fluconazole 200mg PO q24h up to
12 months
Central Nervous Infections
Comments
Alternative
Cloxacillin 2gm IV q4-6h Source control is strongly
(after culture results are available) recommended
Valganciclovir PO 900mg PO q12h Oral valganciclovir is only
for 14-21 days recommended for CMV
polyradiculopathy or mononeuritis
Valganciclovir PO 900mg PO q24h multiplex who has mild motor deficits
for 6 months depending on severity
of disease, time to response and end
organ involvement.
Amphotericin B 0.7-1.0mg/kg/24h IV Lipid formulations of amphotericin
PLUS may be used in cases of severe
Fluconazole 800-1200mg PO/IV nephrotoxicity
q24h for 4-6 weeks
OR
Fluconazole 1200mg PO q24h
PLUS
Flucytosine 100mg/kg/24 h PO for 4
divided doses for 4-6 weeks
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