Treatment of Pneumocystosis (14-21 Days)
| Drug(s) | Dose, Route | Adverse Effects |
|---|---|---|
| First-Choice Agent | ||
| TMP-SMX | TMP (5 mg/kg) plus SMX (25 mg/kg) q6-8h PO or IV (two double-strength tablets tid or qid) | Fever, rash, cytopenias, hepatitis, hyperkalemia |
| Alternative Agents | ||
TMP plus | 5 mg/kg q6-8h PO 100 mg qd PO | Hemolysis (G6PD deficiency), methemoglobinemia, rash, fever, gastrointestinal disturbances |
| Atovaquone | 750 mg bid PO | Rash, fever, hepatitis |
plus | 300-450 mg q6h PO or 600 mg q6-8h IV 15-30 mg qd PO | Hemolysis (G6PD deficiency), methemoglobinemia, neutropenia, rash |
| Pentamidine | 3-4 mg/kg qd IV | Hypotension, azotemia, cardiac arrhythmias (torsades des pointes), pancreatitis, dysglycemias, hypocalcemia, neutropenia, hepatitis |
| Adjunctive Agent | ||
| Prednisone or methylprednisolone | 40 mg bid × 5 d, 40 mg qd × 5 d, 20 mg qd × 11 d; PO or IV | Peptic ulcer disease, hyperglycemia, mood alteration, hypertension |
Abbreviations: TMP-SMX, trimethoprim-sulfamethoxazole.