Prophylaxis of opportunistic infections - 2000
Page by: E.J. Mayeaux, Jr., M.D.
Louisiana State University Medical Center Shreveport, Louisiana
Pathogen Regimen Alternatives
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Candida species Fluconazole (Diflucan), Ketoconazole (Nizoral),
100-200 mg/d po 200 mg/d po
Coccidioides Fluconazole, 200 mg/d Itraconazole (Sporanox),
immitis Po 200 mg/d po
Amphotericin B (Fungizone),
1.0 mg/kg IV Q week
Cryptococcus Fluconazole, Itraconazole, 200 mg/d po
neoformans 100-200 mg/d po
Cytomegalovirus Oral ganciclovir sodium None
(Cytovene), 1 g po tid
Herpesviruses Acyclovir (Zovirax), Acyclovir, 200 mg po
(presumed) 800 mg po qid tid-qid
Histoplasma Itraconazole, 200 mg/d Fluconazole, 200 mg/d po
capsulatum Po Amphotericin B,
1.0 mg/kg IV weekly
Mycobacterium Rifabutin (Mycobutin), Clarithromycin (Biaxin),
avium complex 300 mg/d po 500 mg po bid
azithromycin
(Zithromax), 500 mg (po)
three times a week
Mycobacterium tuberculosis
INH-sensitive Isoniazid (INH)300 mg/d po, Rifampin, 600 mg/d po
plus pyridoxine HCl, for 12 mo
50 mg/d po for 12 mo;
or isoniazid, 900 mg po,
plus pyridoxine, 50 mg po,
twice a week for 12 mo
INH-resistant Rifampin (Rifadin, Rimactane), Rifabutin, 300 mg/d po
600 mg/d for 12 mo for 12 mo
Multidrug-resistant:Consult public health None
Pneumocystis TMP/SMX DS po 80 mg TMP/400 mg SMX po daily;
carinii daily TMP/SMX DS po 3 times a week;
dapsone, 50 mg po bid or 100 mg
po daily; dapsone, 50 mg po daily,
plus pyrimethamine (Daraprim),
50 mg po Q week, plus leucovorin,
25 mg po Q week; dapsone, 200 mg po
every week, plus pyrimethamine,
75 mg po every week, plus leucovorin,
25 mg po every week; pentamidine
isethionate, aerosol (NebuPent),
300 mg every month via nebulizer
Toxoplasma Trimethoprim/sulfamethox- 80 mg TMP/400 mg SMX po
gondii azole, double strength daily or 160 mg TMP/800 mg
(TMP/SMX; Bactrim DS, SMX po three times a week;
Cotrim DS, Septra DS) dapsone, 50 mg/d po,
160 mg TMP/800 mg SMX plus pyrimethamine (Daraprim)
po daily 50 mg po every week, plus
leucovorin calcium
(Wellcovorin) 25 mg po Q week;
Sulfadiazine, 1.0-1.5 g po Clinclamycin HCl (Cleocin HCI),
q6h, plus pyrimethamine, 300-450 mg po q6-8h, plus
25-75 mg/d po, plus pyrimethamine, 25-75 mg/d po,
leucovorin, 10-25 mg plus leucovorin, 10-25 mg po
1-4 times daily
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