Page 96 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 96
Suggested Treatment
Infection/ Condition Comments
Preferred Alternative
Toxoplasma Gondii Encephalitis
Acute Infection Trimethoprim(TMP)/sulfamethoxazole Pyrimethamine* 4 tablets BD for 1 Adjunctive corticosteroids
(80/400mg) TMP 10mg/kg IV/PO day, followed by 2 tablets OD (e.g. dexamethasone) should be
q24h in 2 divided doses for at least administered when clinically
6 weeks PLUS indicated to treat a mass effect
Folinic acid 10-25mg PO q24h associated with focal lesions or
associated edema. Because of the
PLUS potential immunosuppressive effects
Clindamycin 600mg IV/PO q6h for 6- of corticosteroids, they should be
8 weeks discontinued as soon as clinically
feasible
Fansidar®:
Suppressive/ Maintenance Trimethoprim/ Sulfamethoxazole Pyrimethamine 2 tablets daily Sulfadoxine/Pyrimethamine
Therapy (80/400mg) PO 2 tabs q12h 500/25mg
PLUS
Clindamycin 600mg PO q8h Discontinuation:
Consider when on HAART, CD4
PLUS >100 >3 months and viral load well
Folinic acid 10-25mg q24h suppressed
*requires DG approval
Primary Prophylaxis Trimethoprim/ Sulfamethoxazole Dapsone 200mg PO weekly
(80/400mg) PO 2 tabs q24h
PLUS
Pyrimethamine 3 tablets PO weekly
PLUS
Folinic Acid 25mg PO weekly
HPP AMG Human Immunodeficiency Virus 43
