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Table 107-1

Treatment of Pneumocystosis (14-21 Days)

Drug(s)Dose, RouteAdverse Effects
First-Choice Agent
TMP-SMXTMP (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

Dapsone

5 mg/kg q6-8h PO

100 mg qd PO

Hemolysis (G6PD deficiency), methemoglobinemia, rash, fever, gastrointestinal disturbances
Atovaquone750 mg bid PORash, fever, hepatitis

Clindamycin

plus

Primaquine

300-450 mg q6h PO or 600 mg q6-8h IV

15-30 mg qd PO

Hemolysis (G6PD deficiency), methemoglobinemia, neutropenia, rash
Pentamidine3-4 mg/kg qd IVHypotension, azotemia, cardiac arrhythmias (torsades des pointes), pancreatitis, dysglycemias, hypocalcemia, neutropenia, hepatitis
Adjunctive Agent
Prednisone or methylprednisolone40 mg bid × 5 d, 40 mg qd × 5 d, 20 mg qd × 11 d; PO or IVPeptic ulcer disease, hyperglycemia, mood alteration, hypertension

Abbreviations: TMP-SMX, trimethoprim-sulfamethoxazole.