Page 99 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Mycobacterium Avium Complex (MAC) Disease

Treatment Clarithromycin 500mg PO q12h Addition of moxifloxacin 400mg PO Discontinuation:
q24h Consider if patient is on HAART and
Nodular OR viral load well suppressed, CD4 >
Azithromycin 500-1000mg PO q24h OR 100
Levofloxacin 750mg PO q24h or
PLUS to the preferred regime if poor ≥6 months, asymptomatic of MAC,
Ethambutol 25mg/kg PO q24h response and has completed > 12 months of
therapy
PLUS
Rifampicin 600mg PO q24h

Cavitatory, To add
Disseminated Amikacin 10-15mg/kg/q24h IV

Cytomegalovirus (CMV) Disease

CMV Retinitis Intravitreal injections of Foscarnet* (2.4mg/injection) for 1-4 Immune recovery is essential for
ganciclovir (2mg/injection) 1-4 doses doses over a period of 7-10 days successful treatment. Start HAART
over 7-10 days – eye to review within 2 weeks if possible
PLUS
PLUS Ganciclovir 5mg/kg IV q12h for Discontinuation:
Ganciclovir 5mg/kg IV q12h for 14-21 days Consider if patient is on HAART and
14-21 days viral load well suppressed,
Maintenance therapy with CD4 > 100
Valganciclovir* 900mg PO q24h ≥3 months and after 3-6 months of
(if available) CMV treatment.

*Requires DG approval

HPP AMG Human Immunodeficiency Virus 44